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Text-Book 



of 



Osteopathy 



ILLUSTRATED 



Published by the 

American University 

Chicago :: :: Illinois 



Text - Book 



Osteopathy *i? 



ILLUSTRATED 



Published by the 

American University 

Chicago, 111. 



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&T# 



Copyright, 1919 

by 

American University 

All rights reserved 



©CI.A530102 



JUL -5 1919 



Foreword 



A revolution is on regarding the old time-worn 
methods of treating disease. Until ten or fifteen 
years ago, it was a rare occurrence for a sick person 
to be treated in any other way than by the admin- 
istration of drugs or through surgical interference. 

When a patient came to the old-time M. D. and 
he complained of stomach trouble, the doctor would 
look at his tongue, ask a couple of questions, go to 
his medicine shelf and wonder whether he would 
give the patient this or that remedy. He would 
tell the suffering one to take a teaspoonful of it 
three times a day before or after meals and come 
and see him again at some future date. 

It is indeed a far cry from this slip-shod method 
of taking care of sick people to the modern manner 
which the Drugless Physician uses in getting the 
patient well. His fundamental studies teach him 
to proceed along entirely different lines. He takes 
into consideration the laws of heredity, the occupa- 
tion, the environments, the habits, the condition of 
the blood vessels, the workings of the filtering 
apparatus of the body — the kidneys, the in-take of 
oxygen, the absence or presence of muscular or 
bony lesions of the patient's spine — a factor which 
is never even taken into consideration by the 
average physician. 

And after having thus correlated all these various 
findings, the skilled Drugless Practitioner outlines 
a plan of attack that will make the patient a con- 



vert, physiologically speaking. Too many people 
go wrong physically and mentally and what the 
world needs is not Doctors of Medicine, but Doc- 
tors of Health. 

This treatise on Osteopathy presents a few of the 
essentials of only one branch of Drugless Healing. 
For we beg to remind the reader that the applica- 
tion of the principles of Osteopathy alone will cure 
but a small percentage of chronic disorders. , 

Osteopathy derives its name and meaning from 
the words "Osteo," signifying bone, and "pathos," 
suffering, feeling or disease. It was supposed by 
the founders of this method that all diseases were 
caused by some sort of faulty position or adjustment 
of bones. No student of Drugless Healing takes 
this view seriously. It has been swept into the sea 
of oblivion and all there remains of Osteopathy is 
the manual manipulation's which were used in 
Mechano-Therapy long before Osteopathy was ever 
thought of. 

The publishers of this text-book will feel amply 
repaid for their labor in connection with this work 
if it will arouse the reader to a consideration of the 
great eclectic system of Drugless Healing — our 
Course in Advanced Chiropractic. 

In fact, as one prominent physician said: "Oste- 
opathy was all right until Chiropractic stepped in 
and took its place. ,, • 

American University 

CHICAGO, ILL., U. S. A. 



INDEX 



Page. 

Anemia. 44 

Aphasia 27 

Apoplexy 46 

Arterio-Sclerosis 45 

Arthritis, Rheumatoid 92 

Asthma 73 

Ataxia, Locomotor 43 

Bright's Disease, Chronic.. 85 

Bronchitis, Chronic 76 

Catarrh, Chronic Nasal. ... 68 

Centers, Osteopathic 7 

Chorea 28 

Colic, Intestinal 58 

Constipation 61 

Diabetes Mellitus 87 

Diarrhoea, Simple 60 

Dizziness 56 

Dropsy '. . 52 

Dyspepsia, Chronic 54 

Enuresis 86 

Epilepsy 30 

Epistaxis 48 

Examination, Osteopathic. . 10 

Gastric Catarrh, Chronic. . 54 

Goitre, Exophthalmic 71 

Gout 93 

Hay Fever 75 

Headache, Migraine 27 

Heart, Palpitation of 49 

Heart, Valvular Disease of. 50 

Hemorrhoids 62 

Hernia 81 

Hernia, S t r a n g u 1 ation, 

Treatment for 82 

Hernia, Cure of 82 

Indigestion, Intestinal 59 

Infantile Paralysis 36 



Page. 
Jaundice, Catarrhal 53 

Landmarks 9 

Laryngitis, Chronic 69 

Liver Spots 64 

Liver, General Treatment 
of 65 

Nephritis, Chronic Pa- 
renchymatous 85 

Nephritis, Chronic, Inter- 
stitial 85 

Neuralgia, Facial 32 

Neuralgia, Intercostal .... 32 

Neurasthenia 35 

Neuritis, Simple 33 

Neuritis, Multiple 34 

Neurosis, Occupation 37 

Obesity 66 

Osteopathic Treatment, Gen- 
eral 12 

Paralysis, Agitans 41 

Paralysis, Facial 40 

Paralysis, General 42 

Paralysis, Infantile 36 

Pharyngitis, Chronic 70 

Pleurisy, Chronic 77 

Pott's Disease 84 

Progressive Muscular Atro- 
phy . 38 

Rheumatism, Acute and 
Chronic 90 

Rheumatoid Arthritis 92 

Sciatica 94 

Spinal Curvature 83 

Spinal Nerves, Origin of . . . 10 

Torticollis, Wry Neck 96 

Tuberculosis, Pulmonary .. . 79 



Text-Book of Osteopathy 



OSTEOPATHIC CENTERS. 

The Spinal Column is divided, for convenience' 
sake, into six divisions: The Cervical, Brachial, 
Dorsal, Lumbar, Sacral and Coccygeal. The cer- 
vical embraces the four upper vertebrae; the 
brachial, the three lower cervical and first dorsal; 
the dorsal, the first dorsal and including the twelfth ; 
the lumbar, the five lumbar vertebrae; the sacral, 
all of the sacrum; and the coccygeal, the last set 
of ganglia on the inner side of the coccyx. 

The atlas is directly concerned with disturbances 
to the vaso-motors of the eye and ear, and with dis- 
eases of the face. 

The axis and third cervical is a general vaso- 
motor center, through the superior cervical gang- 
lion. It is a center for the side of the head, face, 
eye, nose, pharynx, tonsils and vessels of the brain. 

The third, fourth and fifth cervical is the center 
for hiccoughs, as it is the origin of the phrenics. 

The middle cervical ganglion is situated at the 
fifth and sixth cervicals, and is the center for the 
thyroid gland. It also augments. the heart action. 

The second to sixth dorsal are vaso-constrictors 
to the pulmonary blood vessels. 



8 TEXT-BOOK OF OSTEOPATHY 

The third to seventh dorsal are vaso-motors to 
the arms, through the brachial plexus. 

The heart, thyroid gland, inferior cervical 
ganglion, the vertebral and basilar arteries are sup- 
plied and controlled by the center of the seventh 
cervical and first dorsal. 

The fibres augmenting the heart action come 
from the second, third, fourth and fifth dorsal. The 
first three control the regularity of the rhythm, 
while the fourth and fifth give regularity and 
strength to the beat. 

The stomach center is located at the fourth dor- 
sal on the right side. 

The center for the ciliary muscle is found at the 
second and third dorsal. This is also the center for 
vomiting and for the bronchial tubes and bronchi. 

The origin of the great splanchnic is between 
the sixth and tenth dorsal. The inhibitory, vaso- 
constrictor and secretory fibres are distributed to 
the stomach and small intestines. 

The center for the liver is found between the 
eighth, ninth and tenth dorsal on the right side. 

The center for the spleen is at the ninth and 
tenth dorsal on the left side. This is also the cen- 
ter for the uterus, through the hypogastric plexus. 

The small intestine, kidney and ovary are con- 
trolled by the center in the eleventh and twelfth 
dorsal. 

The second lumbar contains the center for par- 
turition, micturition and the uterus. 



OSTEOPATHIC CENTERS 9 

The center for diarrhoea is situated at the sec- 
ond, third and fourth lumbar. 

The pelvic plexus is formed by the separation of 
the hypogastric plexus into two halves on either 
side of the rectum. The center is located at the 
fourth and fifth lumbar. The fibres are distributed 
to the pelvic organs. 

The anterior divisions of the sacral nerves are 
distributed to the rectum, bladder, sphincter ani, 
vagina and uterus. 

The second and third sacral center controls the 
bladder; the fourth sacral, the vagina; and the 
fourth and fifth sacral, the sphincter ani. 

Landmarks — The following landmarks are of 
importance in locating certain structures. 

The sixth cervical spine will be found at the 
commencement of the esophagus and opposite the 
cricoid cartilage. 

The seventh cervical spine is on a level with the 
apexes of the lungs. 

The eighth thoracic spine is opposite the lowest 
level of the heart and the central tendon of the 
diaphragm. 

The ninth thoracic spine is on a level with the 
cardiac opening of the stomach. 

The lowest level of the lungs is found opposite 
the tenth thoracic spine. 

The eleventh thoracic spine marks the level of 
the lower border of the spleen and upper border of 
the right kidney. 

The renal vessels and pelvis of the kidney are 
on a level with the first lumbar spine. 



10 TEXT-BOOK OF OSTEOPATHY 

The second lumbar spine is opposite the third 
portion of the duodenum and receptaculum chyli. 

The third lumbar spine lies just above the 
umbilicus. 

The fourth lumbar spine marks the bifurcation 
of the aorta and the crests of the ilium. 

The junction of the first and second part of the 
rectum takes place at about the end of the coccyx 

In order to apply the treatment intelligently and 
to understand the lesions properly, it is necessary 
to know where the principal spinal nerves are 
located and their origin. 

ORIGIN OF THE SPINAL NERVES. 

The eight cervical nerves arise from the spinal 
cord above the level of the sixth cervical vertebra; 
the upper six dorsal, between the levels of the 
sixth cervical and fourth dorsal vertebrae; the low- 
er six dorsal, between the fourth and eleventh dor- 
sal vertebrae; the five lumbar, between the levels 
of the eleventh and twelfth thoracic vertebrae ; and 
the sacral, between the last dorsal and first lumbar 
vertebrae. 

OSTEOPATHIC EXAMINATION. 

In order to successfully map out a line of treat- 
ment, all patients should be carefully examined and 
abnormalities noted. Palpation or the use of the 
hand is the method most frequently used. By this 
means dislocations and muscular, tendinous or car- 
tilaginous contractions are often determined. The 
patient should be stripped of all clothing if possible 
and covered with a sheet. It is absolutely essential 



OSTEOPATHIC EXAMINATION 11 

to instruct the patient to offer no resistance ; in fact, 
relaxation must be had as much as possible. The 
operator should be a good regional anatomist, or be 
thoroughly familiar with the outlines of the back. It 
is well to remember that the normal spine has four 
curves, viz. : Cervical, concave backward ; dorsal, 
concave forward; lumbar, concave backward; pelvic, 
in which the concavity is forward. 

Have the patient sit on a chair or stool and stand 
behind him. Carefully examine the spine and curves 
and see if the latter are normal or not. Note if both 
sides of the neck are equal or not ; also examine the 
glands for any enlargements. 

Have the patient assume the dorsal position with 
legs extended, and the muscles relaxed. One hand 
should be placed on the forehead and the other over 
the muscles of the neck, just below the occiput, and 
while rotating the head, manipulate the neck mus- 
cles. The sub-occipital tissues and cervical verte- 
brae should be closely examined. The spinous proc- 
esses can readily be felt if the fingers are moved 
down the median line at the back of the neck. 
Sometimes it requires practice to do this. By press- 
ing the fingers along the transverse processes while 
the head is being rotated, anterior, posterior or 
lateral deviations may be discovered. 

Have the patient resume the sitting posture and 
place his hands on his knees. Instruct him to lean 
over and then examine each vertebra carefully to 
determine any subluxation or dislocation. 

The chest, abdomen and various organs should 
be subjected to a careful examination. 



12 



TEXT-BOOK OF OSTEOPATHY 



GENERAL OSTEOPATHIC TREATMENT. 

The following manipulations constitute a general oste- 
opathic treatment: 

First of all the patient should be placed face downward 
on the table. A pillow may be used for support of the 
head. 

Work deeply all the tissues of the back with both hands, 
alternating the movement of each hand so that they move 
in opposite directions. The spinal muscles may be loos- 
ened with the fingers. (Fig. 1.) 



1-4 
P 




GENERAL OSTEOPATHIC TREATMENT 



13 



Press the thumbs deeply on both sides of the spine at 
the upper lumbar vertebrae and move the muscles upward 
and outward. Work downward until the second sacral 
vertebra is reached. The beneficial effects of this manipu- 
lation is increased if an assistant raises the limbs some- 
what during this treatment. 

Place both hands on the scapulae and with an alternate 
rotary movement loosen and relax the mtascies, (Fig. 2.) 




d 

K 



14 



TEXT-BOOK OF OSTEOPATHY 



Relax the muscles of the spine from the cervix to the 
sacrum by working deeply on both sides and moving them 
upward and outward. 

While pressing hard on the sacrum with one hand, raise 
the limbs with the other and move them from side to 
side. (Fig. 3.) 




GENERAL OSTEOPATHIC TREATMENT 



15 



Turn patient on the side. Grasp the shoulder with one 
hand and rest the patient's arm on yours. While moving 
the arm upward and downward, work deeply the muscles 
in the scapular region so as to cause relaxation. (Fig. 4.) 




FIG. 4. 



16 TEXT-BOOK OF OSTEOPATHY 

With one hand raise the patient's arm as high as pos- 
sible and with the other pull up the scapula. A rotary 
movement of the muscles will loosen them. 

Place one hand under the knee-joint of one of the legs, 
and the fingers of the other hand close to the spine, just 
above the last lumbar vertebra. While slightly lifting and 
lowering the limb, move the muscles upward and outward 
each time. (Fig. 5.) 



The muscles of the spine from the first lumbar verte- 
bra to the lower border of the sacrum may be loosened 
by working the fingers in deeply and moving the muscles 
upward and outward. 

Place the fingers of one hand at the base of the neck 
close to the spine. Take hold of the free arm of the 
patient at the elbow, and while using it as a lever, move 
the muscles upward and outward until the whole of the 
spine has been covered. Turn patient on other side and 
repeat the movements. 

Place one hand on the shoulder-joint and the other 
below the elbow, and rotate the shoulders upward and 
outward twelve to fifteen times. 

Have the patient draw up his legs and brace them 
against your hip and hold them there with one hand. 
Work the muscles of the spine deeply with the fingers 
of the other hand and pull them toward you. Applicable 
to the lumbar area. Both sides should be treated and the 
treatment may last from two to four minutes. 

Place one hand beneath the occiput and lift the head 
against your breast. Stretch the neck and upper dorsal 
spine. 

Grasp the limb in both hands and deeply knead the tis- 
sues so as to cause relaxation. 

Grasp the hip with one hand and the shoulder with the 
other. Push the hands away in opposite directions, there- 
by stretching the spine. 

Turn patient on back. With one hand on the fore- 
head and the other on the muscles in the back of the 
neck, rotate the head while working deeply on the muscles. 
Move the hand down an inch and repeat the manipulations 
until the entire neck has been covered. (Fig. 6.) 



GENERAL OSTEOPATHIC TREATMENT 17 




FIG. 5. 




FIG. 6. 



18 



TEXT-BOOK OF OSTEOPATHY 



Place one hand under the chin and the other over the 
occiput. While an assistant holds the feet, pull slowly and 
steadily for about one minute. Do not rotate the head. 
(Fig. 7.) 




GENERAL OSTEOPATHIC TREATMENT 



19 



Pull and turn the head slightly from side to side. This 
movement may be executed with the patient either in the 
sitting or prone position. 

Grasp the patient by the shoulders and have an assistant 
hold the feet. Extend the spine by pulling steadily in 
opposite directions. 

Flex the thigh strongly on abdomen and turn the knee 
inward and the foot outward. Repeat this movement from 
four to six times. This stretches the sciatic nerve. 
(Fig. 8.) 




^X 



20 



TEXT-BOOK OF OSTEOPATHY 



Flex the thigh strongly against the abdomen and extend 
the leg as much as possible without moving the thigh 
from the abdomen. 

Take hold of the thigh with both hands, the fingers 
meeting if possible, and move the muscles to the bone. 
Treat the other thigh in the same manner. (Fig. 9.) 




GENERAL OSTEOPATHIC TREATMENT 



21 



patient exerts 



Circumduct the limbs while extended. 

Flex and extend the limbs while the 
more or less resistance to the movements. 

Grasp the leg by the knee and flex it strongly a num- 
ber of times against the abdomen. 

Abduct and adduct the knees while flexed; with more 
or less force. (Fig. 10.) 




FIG. 10. 



22 



;_TEXT-BOOK OF OSTEOPATHY 



Press lightly on the ribs directly over the liver and 
apply gentle vibration. Carry the hand down about an 
inch and vibrate the liver for about two or three minutes. 
The other organs may be stimulated in a similar manner 
by placing the hands over the proper areas. 

Have the patient flex his knees. Deeply knead the ab- 
domen and intestines, beginning on the right side near the 
cecum, working upward along the ascending colon, then 
across the transverse colon and down the descending colon, 
following the line towards the rectum. The manipulations 
at first should be light and gradually increased in strength. 
(Fig. 11.) 




FIG. 11. 



GENERAL OSTEOPATHIC TREATMENT 



23 



Same position. Place the hand across the tip of the 
sternum and while pressing deeply in an upward and back- 
ward direction apply vibration. This stimulates the solar 
plexus. (Fig. 12.) 



2 
P 




24 



TEXT-BOOK OF OSTEOPATHY 



Lift the abdominal muscles and intestines between the 
palms of hands. 

Place the flat of the hand over the umbilicus and per- 
form a circular movement to the right without lifting the 
hand. 

Patient sitting. Place one hand on the forehead and 
the thumb and fingers of the other to the sides of the 
uppermost cervical vertebrae. Rotate the head while ap- 
plying firm pressure with the fingers and thumb. 

Place your hands on both shoulders and press gently 
downward while an assistant raises the patient's arms high 
above his head. 

Extend the spine by placing the knee in the patient's 
back in the first and second lumbar areas and the hands 
on his shoulders and drawing the body back against the 
knee and holding it in that manner for a few seconds. 
(Fig. 13.) 




FIG. 13. 



GENERAL OSTEOPATHIC TREATMENT 



25 



Grasp the arms by the wrists and draw them slowly 
above the head while the patient inhales deeply and lower 
the arms with a backward motion. (Fig. 14.) 




FIG. 14. 



26 



TEXT-BOOK OF OSTEOPATHY 



Place the hands upon the sides of the neck with the 
fingers almost meeting over the spines of the upper cervi- 
cals, tip the head backward and press hard upon the vaso- 
motor area. Duration of treatment from three to five 
minutes. 

Bend the patient's head upon his breast and deeply 
knead the muscles of the neck and back. 

sOperator assumes a position in front of the patient. 
The upper arm should be taken hold of with one hand and 
while being held in an upright position, the muscles and 
tissues around the shoulder, spine and back are manipu- 
lated by deep kneading with the other until they are re- 
laxed. Flex and extend the arm while holding the elbow 
with one hand. (Fig. 15.) 




FIG. 15. 



APHASIA 27 

APHASIA. 

Definition — A loss of power of comprehending, 
speaking or writing words, due to cerebral lesions. 

Symptoms — Patient comprehends, but is unable 
to express himself in words. Entire loss of voice 
is not common. Patients suffering from this dis- 
ease have a strong tendency toward using profanity. 

Treatment — Give general treatment, beginning at 
the upper cervix, and include every part of the body. 
Stretch the spinal cord in the following manner: 
Place one hand at the occiput and the other under 
the chin. Pull gently until feet move, rotating head 
while extension is made, and as the head is being 
turned press the fingers of the hand under the neck 
strongly against the sides of the vertebrae, just 
back of the mastoid process. Change hands and re- 
peat the movement. 

Prognosis depends upon the cause. Should be 
guarded. 

HEADACHE. 

Definition — Pain in the head. 

Causes — Headache is always a symptom, never a 
disease in itself. It may be due to derangements 
of the stomach and liver, toxemic conditions, con- 
gestion and anemia of the brain, eye-strain, organic 
diseases of the brain, functional disorders and reflex 
causes. 

Symptoms — The most prominent symptom is 
pain. The character and location varies according 
to the disease it is dependent upon. It may be su- 
perficial or deep, dull or heavy, throbbing or stab- 
bing, general or local, and constant or paroxysmal. 



28 TEXT-BOOK OF OSTEOPATHY 

Treatment — 1. Reduce the heart action by free- 
ing the ribs on left side and hold- 
ing the inferior cervical ganglia. 

2. Raise the clavicles. 

3. Stretch the neck, manipulate the 
neck muscles and stimulate the 
spinal accessory nerve. 

4. Treat the chest, liver, stomach 
and bowels. 

5. To relieve nausea, elevate and 
separate the third, fourth and fifth 
ribs on the right side. 

Acute headache can be relieved in this manner: 
The patient may assume either of the following po- 
sitions, sitting, standing or lying down. Place the 
fingers of both hands on both sides of the cervical 
spines, the upper portion close to the occiput and 
covering the vaso-motor area, and the thumbs on 
the side of the neck, covering the pneumogastric 
nerve. Press gently on the neck with the fingers 
and at the same time press on the nerves mentioned. 

CHOREA. 

Definition — St. Vitus' Dance. Involuntary spas- 
modic muscular twitchings of a neurotic origin. 

Causes — This is usually a disease of childhood. 
Heredity seems to underlie some cases. It may be 
due to reflex conditions, dentition, fright and worms. 
It may follow rheumatism. 

Symptoms — An attack usually comes on gradual- 
ly with spasmodic twitching of the muscles of the 



CHOREA 29 

hands or face. This increases in intensity until all 
qontrol of the muscles of expression are lost. The 
eyelids close spasmodically and the facial muscles 
jerk. Speech is often indistinct and mumbling. 
Swallowing is sometimes difficult. The hands are 
in constant motion, and objects on being taken up 
by the hands are dropped. The gait is stumbling. 
Usually only one side is affected, later both. The 
child is peevish and fretful and is subject to sleep- 
lessness and unpleasant dreams. The appetite is 
poor, patient constipated and anemic, and there is 
a gradual loss of weight. 

An attack usually lasts from six to twelve weeks. 
Usually one attack occurs, but it may recur an- 
nually. 

Treatment — Examine for the cause and remove it. 

1. Give a thorough treatment to the 
spine. 

2. Extend the spine by proper ma- 
nipulation. 

3. Relax the muscles in the cervical 
and upper dorsal regions. 

4. Thoroughly massage the affected 
muscles. 

5. Give a general treatment. 

Each case must be treated individually. No hard 
and fast rules can be laid down for the correction 
of this trouble. Treat all symptoms as they arise. 
Patient should be treated at least three times 
weekly. 



30 TEXT-BOOK OF OSTEOPATHY 

EPILEPSY. 

Definition — Grand Mai or Epilepsy is a disease of 
the nervous system characterized by sudden loss of 
consciousness and often accompanied by convul- 
sions. 

Causes — Nervous heredity seems to play an im- 
portant part in this disease. The abuse of alcohol 
by parents seems to have a decided effect on their 
offspring. The majority of cases occur in early 
life, generally before the age of twenty. The excit- 
ing causes are: Injuries to the head, syphilis, over- 
indulgence in alcoholics, shock, sexual excesses, phi- 
mosis, sun-stroke, acute infectious diseases, denti- 
tion and worms. Autointoxication from putrefac- 
tion in the bowels may give rise to this disease. 

Symptoms — An attack may come on suddenly, but 
is usually preceded by a peculiar sensation resem- 
bling a sound like a rising current of air. The pa- 
tient may suffer from melancholia, vertigo, dizzi- 
ness, gastric distress or headache, flashes of light, 
disturbances of sound, taste or sense of feeling. 
There is usually coldness and numbness of the 
hands, which gradually passes upward and termi- 
nates in paroxysms. The attack may come on with- 
out warning, the patient utters a sharp cry and falls 
te the ground. He first passes into a tonic spasm, 
during which the lower extremities are rigidly ex- 
tended and the upper extremities flexed. The arms 
are bent at the elbows, the hands upon the wrists 
and the fingers tightly closed upon the palms. The 
head is retracted or drawn to one side. The pa- 
tient becomes cyanotic, the face livid and swollen. 



EPILEPSY 31 

This stage is followed by relaxation. All the mus- 
cles of the body are affected. The jaws are tightly 
closed and the tongue often bitten. A frothy saliva 
often tinged with blood issues from between the 
teeth. After a few minutes the spasm gradually 
subsides and the patient passes into a condition of 
coma with stertorous breathing, and then into a deep 
sleep, usually lasting from two to three hours. 

These attacks recur regularly at long or short in- 
tervals. 

Treatment — 1. Give thorough manipulation to 
the neck so as to relax the muscles 
in this region. 

2. Thoroughly relax the muscles of 
the spine and give a general treat- 
ment to the spine itself. 

3. If the sphincter is contracted, re- 
lax same by dilatation. 

4. Give a general treatment to im- 
prove the general circulation. 

5. Correct the reflexes. 

6. Apply pressure at the base of the 
skull, the sub-occipital fossae and 
to the solar plexus. 

7. Thoroughly manipulate the abdo- 
men. 

8. Raise the clavicles and depress the 
first rib. 



This treatment should be given during the inter- 
vals and at least three times a week. 
The diet should consist of light, nutritious food. 



32 TEXT-BOOK OF OSTEOPATHY 

NEURALGIA. 

Definition — A severe pain of paroxysmal character 
distributed along the course of a nerve. It is usual- 
ly functional. 

Causes — Predisposing causes are age, sex, hered- 
ity and anemia. It occurs mostly during middle life 
and is rare in children and old people. It is usually 
the result of an inflammatory or circulatory disturb- 
ance in the nerve trunk. Exposure to cold and in- 
juries are exciting causes. Certain diseases such as 
debility, improper hygiene, overwork and various 
excesses sometimes give rise to this disorder. De- 
cayed teeth are causative factors. 

Symptoms — Pain is the most prominent symp- 
tom. It usually occurs in paroxysms, runs along 
the course of the nerve and is of a darting or burn- 
ing character. Tender points are found along the 
course of the nerve, on pressure. 

Treatment — For facial Neuralgia, apply a hot wa- 
ter bag to the back of the neck and upper dorsal re- 
gion, and also the following measures : 

1. Reduce any vertebral dislocation, 
if present. 

2. Treat the terminal branches of the 
fifth nerve. 

3. Relax the muscles and nerves of 
the neck and back. 

4. Give a thorough abdominal treat- 
ment. 

For intercostal Neuralgia, raise the rib or set the 
vertebrae causing the trouble. Also treat the other 
indications by proper measures. 



NEURITIS— SIMPLE 33 

NEURITIS— SIMPLE. 

Definition — This is an inflammation of the nerve- 
trunks, characterized by pain and paralysis of the 
parts supplied by the affected nerve-trunk. 

Causes — The most common causes are compres- 
sion and wounds or injuries of the nerves. Cold 
and damp are exciting causes, and it may also fol- 
low syphilis and lead-poisoning. 

Symptoms — The most prominent symptom is 
sharp, shooting pains of a burning, tingling or tear- 
ing character along the course of the affected nerve- 
trunk and the area of its distribution. The attack 
may be accompanied by febrile reaction and may de- 
stroy the nerve-trunk, causing wasting and destruc- 
tion of the muscular tissue. There is impairment of 
muscular strength, spasmodic contractions and mus- 
cular cramps. In advanced cases the muscles lose 
their power of contraction when subjected to the 
electric current. Herpetic eruptions may appear on 
the skin. The hair may turn white and fall out and 
the nails become brittle. 

Treatment — 1. Put the patient to bed and advise 
perfect rest. 

2. Apply hot applications. 

3. Gently massage the structures sur- 
rounding the nerve affected. 

4. Remove pressure everywhere. 

5. Remove cranial congestion by 
freeing the pressure on the neck 
veins, by relaxing the muscles. 



34 TEXT-BOOK OF OSTEOPATHY 

NEURITIS— MULTIPLE. 

Definition — A simultaneous or rapid, successive 
inflammation of a number of symmetric nerves, 
characterized by pain, numbness, loss of power, mus- 
cular atrophy and mental disturbances. 

Causes — The most common causes of this disease 
are alcoholism, lead, arsenical or silver poisoning, 
syphilis and malaria. It may follow diphtheria, 
rheumatism and typhoid fever. It is supposed to 
be caused by a specific poison in the blood which has 
a particular influence on the nerve-fibres. 

Symptoms — The onset may be slow or rapid, de- 
pending upon the cause. If due to acute infections, 
the symptoms come on suddenly with a chill, high 
fever, backache, muscular pains, headache and a 
feeling of malaise. There is gastric disturbance, the 
patient is constipated, the tongue is coated and an- 
orexia is present. When due to chronic intoxica- 
tions, the symptoms are not marked, and fever may 
be entirely absent. There is loss of muscular power 
and this gives rise to the characteristic symptom of 
"wrist-drop" and "foot-drop." The sensory symp- 
toms complained of are pain, tenderness, tingling, 
numbness and loss of cutaneous sensibility. As the 
disease progresses, muscular inco-ordination and 
atrophy take place. The knee-jerk is feeble or en- 
tirely absent. In alcoholic cases, delirium, mania 
and delusions often occur. These are associated 
with muscular tremors. The skin is glossy and 
sometimes edematous and the hair and nails under- 
go changes. 

Treatment — Same as for simple Neuritis. 



NEURASTHENIA 35 

NEURASTHENIA. 

Definition — A condition of nervous irritability 
caused by exhaustion of the nerve centers. 

Causes — This is a disease of middle adult life, and 
infrequent in children or old age. It affects both sexes 
about equally. High altitude and climatic extremes 
favor its development. Heredity is often an under- 
lying cause, and also race, the Scandinavians, Slavs 
and Hebrews being particularly subject to it. All 
debilitating conditions may bring on the disease. 
Among the exciting causes, anxiety, worry, grief, 
disappointment, sexual excesses, loss of sleep, fright 
or shock, frequent pregnancies, drug habits and the 
menopause, are most common. 

Symptoms — The most prominent and constant 
symptom is great fatigue, following slight exertion. 
This is associated with a variety of other symptoms, 
mental, gastro-intestinal, and circulatory, involving 
practically every organ and part of the body. The 
patient suffers from headache, backache, insom- 
nia, cerebral and mental irritability. The pa- 
tient cannot read for any length of time with- 
out causing eye-strain. The appetite is varia- 
ble and gaseous eructation and rumbling in the 
bowels are often complained of. This may cause 
gastric distension and cardiac palpitation. The pulse 
is usually rapid and may range from 100 to 140. 
The amount of urine secreted is lessened and of high 
specific gravity. Some patients are subject to fears 
and lack of self-confidence. Loss of weight is com- 
mon to this condition on account of defective nutri- 
tion, but sometimes the patient may have a certain 



36 TEXT-BOOK OF OSTEOPATHY 

amount of fatness. Sexual power is lessened, and 
in some cases impotence may actually exist. As the 
disease progresses, loss of memory is complained of 
and the patient cannot concentrate his mind on one 
subject. This is apparent, however, rather than 
real. 

Treatment — 1. Give a general treatment. 

2. Manipulate the neck and head. 

3. Relax the muscles of the spine in 
upper dorsal and cervical regions. 

4. Vibrate the spine. 

5. Gently stretch the spinal cord. 

6. Stimulate the liver and the glands. 

7. Correct the cause. 

Treat the patient two or three times weekly. 

INFANTILE PARALYSIS— ACUTE ANTE- 
RIOR POLIOMYELITIS. 

Definition — A childhood disease characterized by 
sudden paralysis of one or more limbs or of indi- 
vidual muscle-groups and followed by rapid wasting 
of the affected parts and consequent degeneration 
and deformity. 

Causes — This disease is most prevalent during the 
first three years of childhood and is rare after the 
fifth year. It appears most frequently during the 
hot summer months, but it may occur at any time. 
The exact cause is unknown, but it is believed to be 
due to an infection. 

Symptoms — The onset is usually sudden and is 
followed by fever, vomiting, convulsions and some- 
times coma or loss of consciousness. The fever va- 



INFANTILE PARALYSIS 37 

ries from 102 deg. to 104 deg. F., but in some cases 
fever may be absent. There are pains in the back 
and in the muscles of the extremities. When the 
acute symptoms subside, the paralysis comes on and 
is quite rapid. The paralysis most frequently in- 
volves only one extremity, but sometimes all four 
may be affected at the same time. At the end of 
one or two weeks the acute paralytic attack dimin- 
ishes for several weeks and some improvement takes 
place. Atrophy, however, soon follows and the par- 
alyzed muscles begin to shrink, and the affected 
limb becomes smaller and shorter. The most fre- 
quent deformities resulting from the paralysis are 
talipes vagus and varus. 

Treatment — 1. Give a general treatment. 

2. Thoroughly manipulate and ex- 
tend the spine. 

3. Look for any lesions in the cer- 
vical or lumbar regions and cor- 
rect same. 

4. Treat as you would for general pa- 
ralysis. 

Prognosis — Favorable in some cases and many 
others can be benefited. 

OCCUPATION NEUROSIS. 

Varieties — Writers' cramp, telegraphers* cramp, 
violin or piano players' cramp, etc. 

Definition — This is an affection in which any at- 
tempt to use the fingers at once produces a spasm 
of the muscles of those fingers that are brought into 
play. 

Causes — The exact cause is unknown. Heredity 



38 TEXT-BOOK OF OSTEOPATHY 

is supposed to underlie some cases. The overuse of 
the fingers in one particular line of work is responsi- 
ble in many instances. 

Symptoms — Usually develop gradually. There is 
a feeling of stiffness in the used member and the 
part feels tired and heavy. Spasmodic contractions 
occur. Pain is usually limited to the affected part, 
or it may be more extensive and may be spontaneous 
or induced by using the fingers. Prickling sensa- 
tions and numbness are often present in the crippled 
member. 

Treatment — 1. Thoroughly relax all the muscles 
of the neck, the cervical ganglia 
and the muscles of the dorsal re- 
gion. 

2. Manipulate the structures lying 
along the course of the affected 
nerve. 

3. Apply vibratory treatment to the 
muscular system over the upper 
chest, shoulders, neck and back. 

4. Raise the clavicles, arms and ribs. 

5. Stretch the elbow and shoulder 
joints. 

6. Remove the lesion in every case. 

7. Free the circulation. 
Advise rest. 

Prognosis— Usually unfavorable. 

PROGRESSIVE MUSCULAR ATROPHY. 

Definition — Wasting palsy. A slowly progressive 
wasting and atrophy of certain groups of muscles. 



PROGRESSIVE MUSCULAR ATROPHY 39 

Causes — Most common in males between twenty- 
five and fifty years of age. A predisposing cause is 
the constant use of one set of muscles. Injuries to 
the spinal column, exposure to cold and wet, syphilis 
and lead-poisoning are other causes. It may follow 
such acute diseases as measles, acute rheumatism, 
diphtheria and typhoid fever. 

Symptoms — These usually come on gradually. 
The hand is usually the first affected and gradually 
begins to waste away. The fibres become con- 
tracted, power is lost, there are disorders of sensa- 
tion and the surface is cool. There is also pallor of 
the skin. All the muscles of the body may be af- 
fected except those of mastication and those that 
move the eyeball. 

Treatment — 1. Rotate the head. 

2. Thoroughly manipulate the mus- 

cles of the neck. 

3. Raise the clavicles, chest and arms. 

4. Relax the intercostals. 

5. Apply pressure and vibration to 
the sides of the spine, from above 
downward, in the dorsal and lum- 
bar regions. 

6. Flex and extend the limbs. 

7. Raise the limbs upward or back- 
ward. 

8. Free the circulation. 
Treatment every third day. 



40 TEXT-BOOK OF OSTEOPATHY 

Prognosis — Unfavorable, but the progress of the 
disease can be arrested by proper treatment. 

FACIAL PARALYSIS— BELL'S PALSY. 

Definition — Paralysis of the face. Nearly always 
unilateral. 

Causes — Impairment or destruction of the func- 
tion of the seventh or facial nerve by various dis- 
eased conditions. 

Symptoms — Paralysis usually occurs suddenly. 
On examination one side of the face is found to be 
paralyzed and the unaffected muscles drawn toward 
the sound side. Expression is lost and the natural 
wrinkles and lines are obliterated on the affected 
side. The corner of the mouth is dropped and sa- 
liva dribbles from it. The eyelid on the affected 
side cannot be closed and the eye waters. Swallow- 
ing is seriously interfered with and the tongue is 
directed toward the paralyzed side. The forehead 
cannot be wrinkled. 

Treatment — 1. Relax all the muscles of the neck 
and give freedom to the venous 
return blood. 

2. Extend the neck and give gentle, 
firm and steady rotation. 

3. Thoroughly manipulate the mus- 
cles high up under the angles of 
the lower jaw. Pull these mus- 
cles in different directions. 

4. Manipulate the parotid, submaxil- 
lary and sublingual glands. 

Give a treatment every other day. 



PARALYSIS AGITANS 41 

PARALYSIS AGITANS. 

Definition — This is a chronic disease of the nerv- 
ous system, characterized by tremor or alternate 
contraction and relaxation of the muscles of the 
part involved. 

Causes — Usually occurs after middle life and is 
more common in males than females. Heredity is 
supposed to have some influence. Exciting causes 
are: injuries, mental strain, anxiety, fright, expos- 
ure to cold and wet, and some diseases, such as ma- 
laria and rheumatism. 

Symptoms — These usually come on gradually and 
affect the left hand first. Tremor is the first symp- 
tom noticed, and as the disease progresses it in- 
volves the left foot, then the right hand and right 
foot. The tremor is continuous except during sleep. 
It is increased by excitement and diminished during 
physical work. The muscles become weak, there is 
hesitancy in motion and finally rigidity or spasm 
occurs. The gait is characteristic of this disease. 
The trunk is bent in walking, and in order to main- 
tain equilibrium he walks faster and faster, until he 
either falls or grasps something for support. The 
face becomes fixed and expressionless, saliva drib- 
bles from the mouth, the voice is slow and some- 
times stuttering and the knee-jerk may be exag- 
gerated. Flushing and heat are sometimes com- 
plained of. The mind is seldom affected. The in- 
dex finger moves against the trembling thumb, giv- 
ing the appearance or the movement used in rolling 
pills. 



42 TEXT-BOOK OF OSTEOPATHY 

Treatment— 1. Give a general treatment. 

2. Thoroughly manipulate the neck, 
spine, ribs and clavicles. 

3. Remove all lesions. 

4. Relax the spinal tissues. 

5. Give special attention to kidneys, 
liver and bowels by proper meas- 
ures. 

6. Treat the whole length of the spine 
and free the circulation. 

Prognosis — Unfavorable. The disease may last 
from twenty to thirty years. 

PARALYSIS— GENERAL. 

Treatment — In the treatment of paralysis it is 
first necessary to determine the cause and correct 
any lesions present. 

1. Begin by giving a general treat- 
ment. 

2. Relax the spine and give a sooth- 
ing treatment. Avoid unnecessary 
force. 

3. Thoroughly manipulate each joint. 

4. Pay particular attention to the va- 
rious organs, such as the stomach, 
intestines, liver and kidneys. 

5. Manipulate the muscles of the 
neck so as to cause relaxation. 

6. Raise the clavicles. 

7. Take off pressure everywhere. 
Look for lesions in the spine, ribs, 
hips, innominates and coccyx. 

8. Conclude the treatment by giving 
a general treatment to the spine. 



LOCOMOTOR ATAXIA 43 

LOCOMOTOR ATAXIA. 

Definition — A chronic degeneration of the poste- 
rior columns of the spinal cord and posterior nerve 
roots giving rise to muscular inco-ordination, sharp, 
shooting or neuralgic pains in the limbs, loss of 
sensation and the reflexes. 

Causes — The exact cause is unknown. It may 
follow alcoholic excess, exposure to cold, injury or 
inflammation of the cord, and is often hereditary. 
There is sometimes a history of syphilis and it has 
been known to follow pernicious anemia. 

Symptoms — The first symptoms complained of 
are sharp, piercing or lightning-like pains in the 
lower extremities, enfeebled or lost knee reflex or 
jerk, disordered gait and disturbances of vision.. 
The Argyle-Robertson pupil is present. This is a 
condition where the pupil does not contract to 
light, but does contract during accommodation. 
Romberg's symptom is also present. The patient 
is unable to walk along a straight line, and when 
the eyes are closed is unable to take a step, or to 
stand erect with his feet in juxtaposition without 
swaying or losing his balance. Retention of urine 
and sluggish action of the bladder are not infre- 
quent, while constipation is common. There is loss 
of sexual power and often desire. At times violent 
paroxysms of pain may occur in the epigastric re- 
gion, accompanied by vomiting, but these spasms 
of pain may occur in any of the organs of the body. 

Treatment — 1. Give a general spinal treatment. 
2-> Thoroughly relax the spine by ex- 
^nsion. 



44 TEXT-BOOK OF OSTEOPATHY 

3. Separate the ribs. 

4. Apply rotation and steady press- 
ure to the sciatic nerve about mid- 
way between the great trochanter 
and the ischial tuberosity. 

5. Thoroughly manipulate the abdo- 
men. 

6. Manipulate the lower limbs. 

ANEMIA. 

Definition — Anemia is a condition of the blood 
in which there is a deficiency in its quantity or 
quality; in most cases the number of red blood-cor- 
puscles is diminished. 

Causes — Predisposing causes are pregnancy, me- 
nopause and heredity. Females are most subject 
to it. Among exciting causes may be mentioned 
deficient food, air or sunshine, overwork, mental 
worry or shock, chronic intestinal catarrh, cancer, 
Bright's disease and excessive nursing. 

Symptoms — The principal symptom is unnatural 
pallor of the skin and mucous membranes. There is 
loss of strength, lassitude, nervousness, palpitation, 
shortness of breath, headache, cold extremities and 
menstrual disorders. Constipation is usually pres- 
ent. Systolic murmurs over the aorta, pulmonary 
and carotid arteries are frequently heard. 

Treatment — 1. Begin with a general treatment. 
2. Stretch the neck in the following 
manner: Patient on back. Place 
one hand under the chin and the 



ANEMIA 45 

other at the occiput. Pull gently 
until the patient's feet move ; then 
turn face about one-eighth way 
around and back to a straight line 
with the body and let go. Change 
hands and repeat the movement. 

3. Thoroughly vibrate the abdomen, 
liver, spleen and kidneys. 

4. Apply friction along the spine, 
particularly at the eighth and 
ninth dorsal vertebrae. 

5. Raise the clavicles and ribs. 

6. Stimulate the vaso-motor centers. 
Advise patient to take plenty of outdoor exercise, 

cold baths and deep inhalations. 

The diet should consist of easily digestible and 
nourishing foods. May take plenty of milk between 
meals and at bedtime, eggs, rare meats and ice 
cream. Must not take pickles, vinegar, gravies and 
rich, spicy foods. 

Prognosis — Favorable if treated early. , 

ARTERIO-SCLEROSIS. 

Definition — A hardening of the arteries, due to an 
overgrowth of the connective tissue in the vessel 
and calcareous deposits. 

Causes — Old age, rheumatism, syphilis, malaria, 
lead-poisoning, alcoholism and diabetes. Predispos- 
ing causes are : heredity and chronic nephritis. This 
condition is more common in males than females. 

Symptoms — They are obscure. In many cases 
the pulse is hard and bounding, breathing is diffi- 



46 TEXT-BOOK OF OSTEOPATHY 

cult and insomnia is present. There may be car- 
diac hypertrophy. Some patients may be troubled 
with attacks of dizziness, attacks resembling apo- 
plexy or loss of consciousness. 

Treatment — 1. Give a general Osteopathic treat- 
ment. 

2. Apply stimulation between the 
second and fifth dorsal vertebrae, 
and loosen the muscles with the 
finger tips. 

3. Equalize the circulation of the 
blood throughout the body. 

4. Raise the ribs. 

5. Apply vibration and pressure to 
the liver. 

6. Thoroughly manipulate the abdo- 
men. 

7. Stimulate the solar plexus by ap- 
plying deep, steady pressure, with 
a slightly circular motion, just be- 
low the sternum. The pressure 
should be directed backward and 
upward. 

APOPLEXY. 

Definition — Paralysis from a rupture of a cere- 
bral vessel and consequent hemorrhage into the sub- 
stance of the brain or pia mater. Usually occurs 
after middle life and is rare before the age of forty. 

Causes — Diseases of the blood vessels associated 
with chronic enlargement of the heart, heredity, 
Bright's disease, syphilis, excessive use of liquor, 



APOPLEXY 47 

indiscretions in diet, gout, and excesses of all kinds, 
causing a lowering of vitality. 

Symptoms — Premonitory : Headache, dizziness, 
disturbance of vision, tinnitus aurium, or ringing in 
the ears, insomnia, tremor, epistaxis, thickness of 
speech, loss of memory, and a sensation of tingling 
and numbness in the affected side. 

The attack usually comes on suddenly. There is 
localized headache, vomiting, yawning and sighing, 
increasing mental stupor and finally complete coma. 
Breathing is slow, deep, loud and stertorous. At 
first the pulse is full and slow, often irregular; later 
it may become more frequent. The face is flushed 
and swollen and the lips puffed out and blue. Some- 
times the face is pale. At first the temperature is 
subnormal and higher on the side paralyzed. The 
eyes are injected and the pupils contracted or di- 
lated. Unequal pupils are always a grave symptom. 
Paralysis usually occurs on the side opposite the 
cerebral lesion. 

Treatment — 1. Relax all the muscles in the cer- 
vical region. 

2. Give light manipulation to the 
muscles of the back on both sides 
of the spine. 

3. Reduce dislocation of atlas or axis, 
if dislocation is present. 

4. Raise the clavicle and first rib. 

5. Manipulate the affected nerves and 
muscles. 

6. Keep the bowels open and kidneys 
active by proper movements. 



4S TEXT-BOOK OF OSTEOPATHY 

7. Apply ice bags to head and neck, 
and heat to feet. 
Keep the head high. 
The diet should be mostly liquid. 
Treat daily at first, then three times per week. 

EPISTAXIS. 

Definition — Nosebleed. 

Causes — Alteration in the character of the blood, 
y/eakness of the vascular walls and increased blood 
pressure. Nosebleed usually occurs in the follow- 
ing diseases : Typhoid fever, diphtheria, scurvy, ane- 
mia, and chronic diseases of the heart, lungs, kid- 
neys and liver. It is common at the age of puberty, 
and often replaces menstruation. Other causes are 
cerebral congestion, picking of the nose, ulceration 
and polypi. 

Symptoms — If due to cerebral congestion, it is 
usually preceded by headache, ringing in the ears, 
throbbing of the temples and flushing of the face. 
The symptoms are soon relieved by the loss of 
blood. 

Many times nosebleed comes on suddenly; the 
blood trickles from the nose drop by drop, or it may 
flow rapidly. In "bleeders" the tendency to nose- 
bleed is a dangerous one. It is usually checked 
with great difficulty, and when much blood is lost 
it produces anemia, faintness and dizziness. 

Treatment — 1. Stimulate the superior cervical 
ganglion. 

2. Apply steady pressure at the inner 
canthus of the eye. 



PALPITATION OF THE HEART 49 

3. Relax the muscles over the jugu- 
lars. 

4. Raise the arms over the head. 

5. Compress the facial artery at the 
angle of the inferior maxillary 
bone. 

6. If the above measures fail to check 
the hemorrhage, it will be neces- 
sary to plug the nares. 

PALPITATION OF THE HEART. 

Definition — A too rapid action of the heart, either 
regular or irregular, of inorganic origin. 

Causes — It is more common in women and occurs 
most frequently at puberty and at the menopause. 
In men it is more frequent at or after middle life. 
Mental excitement, grief or fright, diseases of the 
uterus, excessive use of alcohol, tobacco, tea and 
coffee are all conducive to this condition. It is often 
caused by gastric distubrances and is a symptom of 
anemia. 

Symptoms — The chief symptom is the unusual 
action or beating of the heart. The attack may oc- 
cur suddenly, in which case the face grows pale. It 
may be mild or severe and last from a few minutes 
to days. The pulse is rapid, sometimes reaching 
160 beats per minute. There is a feeling of weak- 
ness in the epigastric region and sometimes nausea. 
The cardiac impulse is diffuse and sometimes 
heaving. 

Treatment — 1. Raise the left arm steadily and 
strongly high above the bead. 



50 TEXT-BOOK OF OSTEOPATHY 

2. Raise the clavicles and at the same 
time press the knee between the 
scapulae while the arms are drawn 
upward and backward one or two 
times. 



Prognosis — This condition seldom causes death 
unless prolonged. 

VALVULAR DISEASE OF THE HEART. 

Cause — Disease of the valves of the heart usually 
follows acute attacks of endocarditis. About one- 
half of all cases result from rheumatism or a rheu- 
matic diathesis. It may be caused by systemic poi- 
soning from malaria, chronic rheumatism and syph- 
ilis or chemical irritants. Long muscular strain may 
give rise to this disease, particularly of the aortic 
valve. Malformation of the valves and heredity are 
predisposing causes. More than one-half of all cases 
occur under the age of thirty. 

Sypmtoms — The symptoms vary little in all forms 
of valvular diseases. If marked hypertrophy is pres- 
ent, exercise, mental strain or excitement may bring 
on throbbing headache, dizziness and ringing in the 
ears. Dull headache, flashes of light before the 
eyes and pallor of the face are early symptoms of 
aortic incompetency. At other times dyspnoea may 



VALVULAR DISEASE OF THE HEART 51 

be present. Hot flashes and sweats sometimes oc- 
cur. The patient feels faint on arising suddenly 
and the heart palpitates. Pain may or may not be 
present. The pain may be dull or sharp and extend 
to the shoulders and down the arms, particularly 
the left one. Cough is sometimes present. The pa- 
tient is subject to dreams, is peevish and irritable. 
Differential Diagnosis — In aortic incompetency 
the apex beat is directed downward and outward; 
the diastolic murmur is transmitted down the left 
side of the sternum. 

In aortic stenosis the apex beat is not so far dis- 
placed, while the systolic murmur in the aortic area 
is transmitted to the carotids. 

In mitral incompetency the apex beat is rarely di- 
rected below the sixth interspace. It may, however, 
extend to the anterior axillary line. The systolic 
murmur at the apex is transmitted to the axilla and 
is often heard in the back at the angle of the scapula. 

The impulse is not marked in mitral stenosis. 
The presystolic murmur heard at the apex is loud 
and rough in character. 

Tricuspid incompetency gives rise to pulsation in 
the epigastrium and jugular veins. The systolic 
murmur at the lower end of the sternum is trans- 
mitted to the right or left. 

In tricuspid stenosis there is a weak pulsation in 
the jugulars and a presystolic murmur is heard at 
the lower right border of the sternum. 

Pulmonary incompetency causes pulsation in the 
jugulars and the diastolic murmur is transmitted 
down the sternum. 



52 TEXT-BOOK OF OSTEOPATHY 

In pulmonary stenosis the veins are dilated and 
the systolic murmur is transmitted toward the left 
shoulder. The second pulmonic sound is weak. 
General Treatment — 1. Appy the treatment care- 
fully and not too long or 
too severely. 

2. Equalize the circulation. 

3. Give a general treatment. 

4. Relax the muscles in the 
cervical and dorsal re- 
gions. 

5. Raise the ribs and sepa- 
arate those on the left 
side. 

6. Raise the clavicles. 



Treatment may be varied according to condition. 
The aim should be to correct the lesion and take off 
pressure everywhere. 

DROPSY. 

Definition — An accumulation of serous fluid in the 
connective tissue spaces and serous cavities of the 
body, causing abdominal distension and displace- 
ment of the viscera. 

Causes — The principal cause is obstruction of the 
portal system. It often follows cirrhosis of the 
liver, diseases of the lungs and heart, or pressure 
to the venous circulation from tumors or cancer. 

Symptoms — Abdominal distension and constipa- 



DROPSY 53 

tion are most prominent. The amount of urine se- 
creted is small and respiration is greatly interfered 
with. By holding one hand on one side of the ab- 
domen and tapping lightly with the fingers on the 
other side of it, a wave-like impression is usually 
elicited. The umbilicus is forced outward. 

Treatment — 1. Remove all undue pressure on the 
heart and lungs. 

2. Stimulate the vaso-motor area. 

3. Raise the arms and clavicles. 

4. Stimulate the spine from the cer- 
vical to the sacral. 

5. Apply vibration to the abdomen. 

6. Knead the bowels, liver and 
spleen. 

7. Stimulate the renal sphlanchnics 
and lumbar area. 

8. Apply stimulation to the kidneys 
by proper treatment. 

9. Give a general treatment to tone 
up all the tissues of the body. 

CATARRHAL JAUNDICE. 

Definition — Catarrh of the bile ducts or an inflam- 
matory condition of the mucous membrane lining 
these ducts and duodenum. 

Causes — Overloading the stomach with food or 
drink, pressure from any cause and a deficiency of 
normal secretion. 

Symptoms — There is a feeling of distress in the 
epigastrium, accompanied with more or less pain, 
nausea, anorexia, coated tongue, diarrhoea and col- 



54 TEXT-BOOK OF OSTEOPATHY 

icky pains, the stools assuming a clay color, urine 
dark colored , and loaded with constituents of the 
bile, the eyes are yellow and the skin also assumes 
a yellow cast. Slight fever may be present. The 
liver is sore to the touch. Mental depression often 
accompanies this disease. 

Treatment — 1. Stimulate the vaso-motor area 
and pneumogastric nerve. 

2. Manipulate the muscles of the 
neck. 

3. Raise the clavicles and chest mus- 
cles. 

4. Stimulate the dorsal region and 
relax the muscles. 

5. Have the patient lie on the left 
side or back and vibrate the ab- 
domen and liver. 

6. Knead the liver and bowels. 

7. Press upward beneath the seventh 
and tenth cartilages on the right 
side. 

8. Give the colon a thorough treat- 
ment. 

9. Manipulate the lower limbs. 
Have patient drink plenty of water and eat only 

light, nourishing and easily digestible foods. 

CHRONIC GASTRIC CATARRH. 

Definition — A chronic catarrhal inflammation of 
the mucous membrane of the stomach. 

Causes — Usually follows repeated attacks of acute 
gastritis, and results from a disturbance in the peptic 
glands. 



CHRONIC GASTRIC CATARRH 55 

Symptoms — The prominent symptoms usually 
complained of are distention after eating, tenderness, 
an uneasy gnawing sensation and burning pain in 
the stomach ("Heartburn"), cough, eructation of 
gas, nausea, and a feeling of oppression. Very often 
the gaseous distention may cause cardiac palpita- 
tion and dizziness. The tongue is heavily coated, 
the breath foul and there is a bad taste in the mouth. 
The patient is melancholy and ambitionless. The 
symptoms are so variable that no correct classifica- 
tion can be made, but given a case where the ma- 
jority of the symptoms mentioned are present, you 
cannot make a mistake in diagnosis. 

Treatment — 1. Relax all the muscles of the neck 
and correct any lesions present. 

2. Raise the clavicles. 

3. Stimulate the vagus nerve. 

4. Apply steady pressure to the spine 
along the dorsum and splanchnic 
region. 

5. Move the spinal muscles on both 
sides upward and outward, espe- 
cially from the fifth to the tenth 
dorsal. 

6. Deeply knead the lower bowel 
and lift same. 

7. Spread the diaphragm. 

8. Raise the ribs. 

9. Stimulate the solar plexus. 
Advise long, deep breathing four to six times 

daily. Pay particular attention to the diet. Articles 
of food causing the least amount of fermentation 
should be allowed. 



£6 TEXT-BOOK OF OSTEOPATHY 

VERTIGO. 

Definition — Dizziness is a condition in which ob- 
jects about a person seem to be moving rapidly to 
and fro or in a circle. 

Causes — This condition is dependent upon many 
causes. It may be due to eye-strain or near-sighted- 
ness, gastric or nervous disorders, and as a result 
of interference with the cerebral circulation. Dizzi- 
ness dependent upon gastric disorders is most com- 
mon, such as constipation, derangement of the liver 
or stomachic and intestinal indigestion. 

Symptoms — The most prominent symptom of all 
forms of this trouble is the sensation or conscious- 
ness of rapidly moving objects before the patient, 
or he may experience the feeling of moving around 
objects which remain stationary. An attack comes 
on suddenly. The vision becomes indistinct and the 
thoughts confused. The patient experiences a sense 
of sinking and may fall unless he grasps something 
for support. Nausea and vomiting and palpitation 
of the heart are quite frequent accompaniments. 

Treatment — 1. Correct the cause. If due to eye- 
strain, remove the trouble by rest 
and properly fitting glasses. 

2. Give a general treatment, particu- 
larly to the neck and spine. 

3. Apply pressure beneath the clavi- 
cle to reach the fibres of the car- 
diac plexus. 

4. Apply pressure on the occiput and 
atlas while the head is thrown 
well back. 



GASTRIC DILATATION 57 

5. Stroke the jugulars downward. 

6. Raise the clavicles. 

7. Correct any cervical lesions. 

GASTRIC DILATATION. 

Definition — An increase in the normal capacity of 
the stomach. 

Causes — Pyloric obstructions (tumors, scar tissue, 
tight lacing and outside pressure), weakness of its 
muscular walls, gastric ulcers, overloading of stom- 
ach, and chronic gastric catarrh. 

Symptoms — The tongue is usually coated, the 
breath foul and the appetite fitful. The appetite 
may be increased or entirely gone. The patient 
suffers greatly from thirst. Erucations of foul smell- 
ing gas and regurgitation of sour fluid are often 
present. Vomiting usually comes on when the dis- 
ease is well advanced. There is usually great dis- 
tress after eating, and palpitation of the heart is not 
infrequent. Constipation is marked and the quan- 
tity of urine reduced. The general health is affected 
and emaciation gradually takes place. 

Treatment — 1. Advise against the use of fluids 
during meals. 

2. Equalize the nerve force by re- 
moving the pressure from the 
splanchnic and pneumogastric 
nerves. 

3. Stretch the abdominal muscles. 

4. Give a general abdominal treat- 
ment. 



58 TEXT-BOOK OF OSTEOPATHY 

INTESTINAL COLIC. 

Definition — An acute spasmodic pain in the intes- 
tines, characterized by paroxysms of griping, neural- 
gic, abdominal pain. 

Causes — It occurs mostly in nervous, hysterical 
or anemic persons. The most direct causes are ac- 
cumulations of indigestible food in the bowels, 
worms, poisonous drugs, diseases of the uterus, 
liver, kidneys or bladder, acting reflexly, autointoxi- 
cation and exposure to cold. 

Symptoms — An attack often comes on sudden- 
ly. There is usually localized paroxysmal pain 
around the umbilicus, and is of a sharp and tearing 
character. The limbs are usually flexed, and press- 
ure on the abdomen gives relief. Flatulency is pres- 
ent and sometimes a large amount of gas is expelled 
from the stomach and bowels. Nausea and vomit- 
ing are not infrequent. Constipation is the rule, and 
the abdomen is tympanitic. The pulse is small and 
hard, the face pale, anxious and pinched. The pa- 
tient is subject to cold sweats. Fever is usually 
absent, although a slight rise is not infrequent. 
Moreover, the temperature is often found to be sub- 
normal. 

Treatment — Grasp the patient's right arm and 
stretch it strongly up to the side of the head. At 
the same time press witlnthe fingers of the other 
hand on the right side of the spinous processes from 
the fourth to the eighth dorsal vertebrae, the arm 
being let down quickly for a few times, as the fin- 
gers are lowered along the spine. 



INTESTINAL INDIGESTION 59 

If any other condition is present give indicated 
treatment. 

INTESTINAL INDIGESTION. 

Definition — Inability of the intestinal fluids to di- 
gest food. 

Causes — Imperfect diet, use of tobacco, diseases 
of the stomach, liver and pancreas, lack of exercise 
and nervous exhaustion. 

Symptoms — The most prominent symptoms are 
pain, flatulency, rumblings in the bowels due to gas, 
loss of appetite, headache, diarrhoea alternated with 
constipation, colic and pain in the limbs. In the 
chronic form there is dizziness, insomnia, ringing in 
the ears, cardiac disturbance, anemia, high-colored 
urine and emaciation. 

Treatment — 1. Free all the muscles of the neck. 

2. Raise the clavicles, shoulders and 
chest muscles by raising the arms. 
Treat the spine as far down as the 
twelfth dorsal with the fingers, 
while the arms are raised, pulling 
the muscles strongly upward and 
outward each time the arms are 
raised. Treat both sides. 

3. Manipulate the liver, stomach and 
bowels slowly and deeply for fif- 
teen or twenty minutes. 

4. Relax the sphincter muscles. 

5. Give a general treatment. 

6. Flush the bowels with warm wa- 
ter every night. 



60 TEXT-BOOK OF OSTEOPATHY 

7. Treat diarrhoea, if present. 
Treat patient every other day. 

SIMPLE DIARRHOEA. 

Definition — An unusual frequency in evacuation 

of the bowels, characterized by liquidity of the 
feces. 

Causes — Diarrhoea occurs most frequently in neu- 
rotic individuals as a result of fatigue, fear, excite- 
ment, and shock or nervous exhaustion. It may be 
brought on reflexly by gastric disturbances, teeth- 
ing and exposure to cold. Overloading of the stom- 
ach, fresh or unripe fruits and decomposing articles 
of food in the intestines frequently give rise to this 
disorder. 

Symptoms' — The most important symptom is the 
considerable increase in the number of bowel move- 
ments, more particularly in the morning soon after 
arising. The stools are usually fluid in character 
and free from blood, mucus or pus. The stools may 
contain partially digested food. In some cases no 
other symptoms are manifest, while in others there 
is dizziness, palpitation of the heart, a feeling of 
oppression, and flashes of heat and cold. Sometimes 
the abdomen is distended with gas, the tongue is 
coated and headache is present. 

Treatment — 1. Extend the spine by placing the 
knee in the patient's back in the 
first and second lumbar areas and 
bending the body back against the 



SIMPLE DIARRHOEA 61 

knee and holding it in that man- 
ner for a few seconds. 

2. Place the patient on abdomen and 
apply steady pressure on either 
side of the spine from the middle 
dorsal region to the coccyx for 
about ten minutes. 

3. Extend the legs backward while 
the hand is placed in the lumbar 
region of the spine. 

4. Completely relax all the tissues of 
the spine and back. 

5. Give other treatment to meet in- 
dications. 

CONSTIPATION. 

Definition — An infrequent or difficult evacuation 
of the feces. 

Causes — Persons of a bilious or nervous tempera- 
ment are mostly subject to this condition. Seden- 
tary habits, lack of exercise, prolonged mental work, 
and anxiety or worry are the most frequent causes. 
Irregular habits, diet and drugs and the constant use 
of cathartics are usually exciting causes. It may 
also be associated with other intestinal disorders. 

Symptoms — The abdomen is usually distended. A 
considerable amount of gas is passed, and often col- 
icky pains are present. The symptom most promi- 
nent is absence of regular fecal evacuation. Asso- 
ciated with \his disorder are coated tongue, bad 
taste in mouth, nausea, dizziness, belching of gas, 



62 TEXT-BOOK OF OSTEOPATHY 

fitful appetite and irregular pulse. A large fecal 
mass can usually be felt on inspection and palpation. 

Treatment — 1. Correct vertebral lesions. (The 
lower half of spine will usually be 
found the cause.) 

2. Manipulate the liver by vibration 
and kneading. 

3. Knead the bowels along the line 
of the colon. 

4. Knead the abdomen. 

5. Set the coccyx, if dislocated. 

6. Dilate the sphincter ani with a 
rectal dilator. 

7. Relax the muscles of the lower 
part of the back by proper meas- 
ures. 

8. Raise the lower ribs. 

9. Extend the neck and neck mus- 
cles. 

10. Apply vibration to the spine from 
the first to the fourth sacral ver- 
tebra. 

Diet — Drink plenty of water, buttermilk and acid 
beverages. Eat cooked fruits, vegetables and hon- 
ey. Avoid too much starchy foods and sweets. 

Cases should be treated at least twice a week. 
HEMORRHOIDS OR PILES. 

Definition — This is an enlarged or varicose con- 
dition of the hemorrhoidal veins and tissues around 
the anus, either internal or external. 



HEMORRHOIDS OR PILES 63 

Causes — Anything which obstructs the free cir- 
culation of the blood in the portal system will give 
rise to hemorrhoids. The use of alcoholics, on ac- 
count of their irritating effect on the liver, is a pre- 
disposing cause. Constipation, straining at stool, 
diarrhoea and dysentery, rough toilet paper, un- 
cleanliness, pelvic tumors, displacement of the 
uterus and pregnancy are among the most common 
causes. 

Symptoms — Unless inflamed, external piles cause 
very little discomfort. If inflamed, the tumor is 
usually reddened, swollen, hard and excessively ten- 
der and painful. 

The symptoms of internal piles depend upon 
their size and character. If protruded or ulcerated, 
there is a feeling of fullness and heat in the rectum, 
a frequent desire to empty the bowel and a dull 
aching pain. On account of their tendency to bleed, 
internal hemorrhoids are called "bleeding piles." 
The intensity of these symptoms is increased ac- 
cording to the amount and extent of the inflamma- 
tion. 

Internal piles are situated within the Sphincter 
Ani, while external piles are just at the anal margin. 

Treatment — 1. Relax the structures in the ischio- 
rectal region. 

2. Correct any dislocation of the 
coccyx, a sub-luxation of the in- 
nominate or lumbar lesion. 

3. Anoint the forefinger with ster- 



64 TEXT-BOOK OF OSTEOPATHY 

He vaseline and introduce it into 
the rectum with the palmar sur- 
face turned backward. Reach up 
and backward above the sphincter 
muscle and examine the coccyx. If 
dislocated, correct it. Then exer- 
cise considerable pressure and 
pulling on the muscular struc- 
tures on either side of the coccyx, 
sideways and backward, and at 
the same time stretch the 
sphincter. Press on whatever 
tumors are found in the rectum, 
and by slow, gentle manipulation, 
work them until softened. In 
withdrawing the finger, clasp the 
integument with the thumb so as 
to offer some resistance. 

4. Pressure on the sacral nerves on 
the outside of the sacrum will 
desensitize the nerves and make 
the internal treatment less painful. 

5. Correct the constipation by prop- 
er treatment. 

Treat the patient every third or fifth day. 

LIVER SPOTS. 

Definition — This is a pigmentation of the skin of 
a yellowish, brownish or black color. 

Causes — It may be caused by the action of any 
irritant on the skin, such as blisters or follow 



LIVER SPOTS 65 

scratching, pressure and friction. It may be asso- 
ciated with visceral and general diseases, such as 
uterine diseases and pregnancy, malaria, tubercu- 
losis, cancer and Addison's disease. The most com- 
mon cause is pregnancy. 

Symptoms — The patches are yellowish or brown- 
ish in color and are usually located around the fore- 
head and eyelids. The patches may vary in size 
and shape, being either irregular or round. 

Treatment — 1. Restore the normal circulation by 
manipulations. 

2. Give the liver a good general 
treatment. 

3. Apply vibratory movements over 
the surface affected. 

4. Apply stroking over the surface 
affected. 

5. Advise the application of hot 
cloths to the spots. 

LIVER— GENERAL TREATMENT. 

This gland is subject to many diseases primarily 
and very often is involved with other constitutional 
disorders. For this reason, a systematic outline of 
treatment, similar to that given below, should be 
followed in all cases. The order of treatment may 
be varied to suit each individual case. 

1. Stimulate the liver by treating the upper part 
of the back from the sixth dorsal to the first lum- 
bar. 

2. Raise the ribs. 



65 TEXT-BOOK OF OSTEOPATHY 

3. Stretch and manipulate the muscles of the 
chest, abdomen and dorsal region. 

4. Vibrate the abdomen and liver, 

5. Place the patient on the back and thoroughly 
knead the liver. 

6. Give a deep careful abdominal treatment. 

7. While the patient is sitting, stand behind him, 
reach around in front and as he expels air after a 
deep inspiration, lift the abdominal wall and press 
up beneath the eighth, ninth and tenth ribs. 

8. Place the patient on the left side and vibrate 
the abdomen lying over the liver. 

Advise the patient to take plenty of gymnastic 
exercises outdoors. Advise the drinking of large 
quantities of water, and prohibit the use of all 
liquors. 

OBESITY. 

Definition — An excessive development of fat 

throughout the body. 

Causes — Heredity is supposed to have a great 
deal to do with this condition. An over-indulgence 
in carbohydrates, fats and albumins is the most fre- 
quent cause. Defective oxidation from whatever 
cause may frequently give rise to this condition. 
Beer drinkers are particularly subject to obesity, 
the alcohol in the beer hastening the metabolism of 
albumin. 

Symptoms — The most prominent symptom is the 
increase in bulk of the patient. He may increase to 
such size that it interferes with locomotion, in which 



OBESITY 67 

case the movements are sluggish and the gait wab- 
bling. Dyspnoea may occur owing to the respira- 
tion being interfered with by the fatty chest-wall or 
enlarged liver. The disorder may cause fatty infil- 
tration of the heart-muscles and terminate in death. 

Treatment — 1. Stimulate the liver, pancreas and 
lymphatic system. 

2. Raise the clavicles and lower first 
ribs. 

3. Give a thorough treatment to the 
spine. 

4. Apply deep kneading over the fat. 

5. Give general treatment. 

Advise the patient to exercise daily and walk con- 
siderably in the open air. 

Diet is very important in this disease and the fol- 
lowing list will be found serviceable : 

The patient may be allowed to take nearly all 
kinds of fresh fish, boiled; lean beef, mutton or 
lamb, chicken and game (sparingly) ; boiled or 
poached eggs on toast; stale bread, dry toast or 
crusts (sparingly) ; spinach, lettuce, celery, cresses, 
asparagus, cauliflower, onions, white cabbage, toma- 
toes, radishes, olives; ripe fruits only — acid vari- 
eties preferable; one cup of tea or coffee, without 
milk, cream or sugar, or one glass of pure water, 
sipped at end of the meal. 

He must not take soups, salmon, bluefish, eels, 
salt fish, pork, veal, sausage, made dishes, fats, pota- 
toes, macaroni, oatmeal, hominy, spices, rice, beets, 
carrots, turnips, parsnips, puddings, pies, pastry, 



68 TEXT-BOOK OF OSTEOPATHY 

cakes, sugars, sweets, milk, cream, malt or spiritu 
ous liquors, beers, sweet wines, champagne. 

CHRONIC NASAL CATARRH. 

Definition — A chronic inflammation of the nasal 
mucous membrane, with more or less change in 
structure. 

Causes — It is usually the result of repeated at- 
tacks of acute catarrh, or inhalation of irritating 
gases or dust. Syphilis and scrofula are also pre- 
disposing causes. 

Symptoms — The nostrils feel full and secretion is 
increased. The secretion is usually thick and green- 
ish, and when dropping down into the pharynx, it 
sets up an irritation which causes paroxysms of 
hawking and spitting. This is usually worse in the 
morning on arising. The sense of smell is more 
or less impaired. Hearing is lessened, due to exten- 
sion of the inflammation to the Eustachian tubes. A 
dull frontal headache is almost constantly present. 
Sudden changes of temperature always cause ex- 
acerbation of these symptoms. 

Treatment — 1. Manipulate and stretch the mus- 
cles of the back of the neck. 

2. Rotate the head in extension. 

3. Manipulate the angles of the in- 
ferior Maxillary. 

4. Vibrate the ears and temples. 

5. Manipulate the forehead. 

6. Vibrate the facial nerve. 

7. Apply pressure on the nose at the 
inner canthus. 



CHRONIC LARYNGITIS 69 

8. Raise the clavicles. 

9. Extend the chest muscles and ribs 

by deep inspiration. 

10. Stretch the neck. 

11. Adduct and abduct the head. 
Treat three times weekly. 

Prognosis must be guarded. 

CHRONIC LARYNGITIS. 

Definition — A chronic inflammation of the mucous 
membrane of the Larynx. 

Causes — Repeated attacks of acute Laryngitis, 
catarrh involving the respiratory tract, excessive 
and improper use of the voice, inhalation of dust or 
chemicals and alcoholism. Not infrequently, gas- 
tric disturbances will give rise to this condition. 

Symptoms — There is a tickling sensation in the 
throat, the voice is hoarse and husky, the patient is 
troubled with persistent cough and expectorates a 
thick, tenacious whitish mucus. An examination of 
the larynx will reveal a hyperaemic or congested 
condition and small granulations in certain portions 
of the mucous membrane. The vocal cords are red- 
dened. Hawking is a common symptom. 

Treatment — 1. Thoroughly relax all the tissues 
of the neck, both in front and 
back. 

2. Manipulate the tonsils. 

3. Manipulate the muscles of upper 
oart of the chest and back. 



70 TEXT-BOOK OF OSTEOPATHY 

4. Open the mouth against res ; ~ 
ance. 

5. Press the hard palate w ; 
finger. 

6. Apply vibration to the region jus: 
below the lobule of the ear, on the 
ninth, tenth .and eleventh nerves. 

7. "Work deeply along the trachea 
and larynx. 

The patient should be treated every other day. 

CHRONIC PHARYNGITIS. 

Definition — A chronic catarrhal inflammation of 
the mucous membrane of the Pharynx. 

Causes — It usually follows an acute attack of 
Pharyngitis. Excessive straining of the voice and 
constant inhalation of dust or tobacco are common 
causes. 

Symptoms — Cough is frequent and hacking in 
character, the voice is hoarse, tires very quickly and 
may be lost entirely. Sometimes there is pain on 
swallowing and the patient complains of a sensa- 
tion as if a foreign body was lodged in the throat. 
In some cases, expectoration is profuse, and the 
thick, tenacious mucus may be tinged with blood. 

Treatment — 1. Relax all muscles of the neck and 
stimulate the superior cervical 
sympathetic. 

2. Take off pressure from jugulars. 

3. Apply compression to the ninth 
and tenth nerves. 



EXOPHTHALMIC GOITRE 71 

4. Vibrate the mucous membrane of 
tonsils and pharynx (internal 
treatment). 

5. Depress the first ribs and raise the 
clavicles. 

6. Give spinal treatment. 

7. Manipulate the abdomen. 
The patient should be treated twice a week. 

EXOPHTHALMIC GOITRE. 

Definition — This is a disease of the thyroid, in 
which the gland is enlarged, the eyeballs promi- 
nent, the pulse accelerated and muscular tremors 
present. 

Causes — Goitre occurs more frequently in women 
than men and usually between the ages of fifteen 
and twenty-five. Heredity is supposed to underlie 
some cases. Predisposing causes are sudden fright, 
grief, anxiety and fatigue or mental shock. It often 
follows such diseases as rheumatism, influenza or 
typhoid fever. The theory advanced to-day and the 
most plausible cause is the irritant action upon the 
central nervous system of a perverted or increased 
secretion of the gland. 

Symptoms — Enlargement of the thyroid gland, 
tremors, abnormal protrusion of the eyeballs and 
rapid heart action are common. The pulse usually 
varies from 90 to 160 beats per minute. Von Graefe's 
sign is often present. This is the inability of the 
upper lid to follow the movement of the eye when 
looking down or up. Another sign usually present is 



72 TEXT-BOOK OF OSTEOPATHY 

Dalrymple's. This is a widening of the fissure be- 
tween the lids. In simple goitre the enlargement is 
greater than in the Exophthalmic form of this dis- 
ease. The enlargement is usually symmetrical, but 
occasionally unilateral. 

The nervous symptoms present are restlessness, 
irritability, headache, neuralgia, insomnia and mus- 
cular weakness. Sometimes vomiting and diar- 
rhoea occur, as well as edema of the ankles. Res- 
piration is increased and anemia and loss of weight 
are common results. Albumin may appear in the 
urine and the quantity of urine excreted in twen- 
ty-four hours may be large. 

Treatment — 1. Extend the muscles of the neck. 

2. Rotate the head. 

3. Thoroughly manipulate the mus- 
cles of the face and neck. 

4. Stimulate the vaso-motor area. 

5. Elevate the clavicles and manipu- 
late the gland upward. 

6. Knead the sides of the gland. 

7. Apply light, but firm pressure to 
the gland. 

8. Raise the arm upward and back- 
ward and at the same time ele- 
vate the clavicles. 

9. Relax the upper dorsal spine and 
keep the upper ribs raised. 

10. Apply vibration just below the 
ear. 

11. Give a general treatment. 



ASTHMA 73 

Treatment should be given two or three times 
weekly. 

ASTHMA. 

Definition — A disease characterized by paroxys- 
mal attacks of dyspnoea and a feeling of oppres- 
sion. 

Causes — This is essentially a nervous affection 
and is caused by some irritation on the central 
nervous system. It is often hereditary. Patho- 
logical conditions of the air passages, such as ade- 
noids, polypi, nasal spurs or bronchial catarrh are 
probable causes. Exciting causes are dust, tobac- 
co, pollen of plants and certain drugs. It may fol- 
low gastric disorders, especially an overloading of 
the stomach. Asthma is also symptomatic of hay 
fever, Bright's disease and affections of the heart. 
There is a spasmodic closure of the bronchi. 

Symptoms — The onset is usually sudden or may 
be preceded by a feeling of oppression about the 
chest, chilliness, flatulence and sneezing. The at- 
tack usually comes on at night or in the early 
morning hours, the patient being awakened by dysp- 
noea. The desire for air is intense and he assumes 
the position which gives him the greatest relief, 
which is usually that of leaning forward upon his 
arms. The respiration is not increased in rapidity. 
During an attack the face becomes flushed and at 
times livid, the eyes prominent and the skin cold 
and clammy. An attack usually lasts from half an 
hour to several hours and terminates with the ex- 
pectoration of sticky, stringy mucus. On close ex- 
amination, this mucus reveals little grayish balls, 



74 TEXT-BOOK OF OSTEOPATHY 

called Curshmann's spirals, which may sometimes 
be seen with the naked eye. The temperature is 
seldom elevated, but the pulse is slow and weak. 
At times, however, the pulse is rapid, small and 
irregular. , 

Treatment — 1. Manipulation of cervical area, per- 
formed as follows: While both 
arms are strongly raised, apply 
pressure with the fingers on either 
side of the spinous processes 
along down the back, beginning 
on a level with the shoulders, or 
press the knee against the back 
while the arms are pulled strong- 
ly upward and backward, loosen- 
! ; ing the hold and lowering the 

pressure in the back three or four 
times, until the first six dorsal 
vertebrae are passed with the 
knee downward. 

2. Give a general treatment. 

3. Vibrate the entire chest with hand 
or hands for several minutes. 

4. Raise the clavicles. 

5. Stretch the body backward while 
pressing along the sides of the 
spinous processes with the fingers. 

6. Pressure applied at the head of 
the first rib will relieve the most 
violent paroxysms. 

Treat every second or third day. 



HAY FEVER ' 75 

HAY FEVER. 

Definition — An acute catarrhal inflammation of 
the nasal mucous membrane and upper air passages. 

Causes — Predisposing causes are: Heredity and 
excitable conditions of the nervous system. Inhala- 
tion of the pollen of roses, corn, wheat, grasses and 
rye are excitants. 

Symptoms — A typical attack resembles an acute 
cold. There is sneezing, a clear, watery, nasal dis- 
charge, congestion of the Eustachian tubes, finally 
involving the larynx and bronchial tubes, difficult 
breathing and a croupy cough. The cough is 
wheezy and dyspnoea often occurs in paroxysms. 
These paroxysms may cease after a few days, re- 
turning again for several days or weeks and again 
cease, etc. 

Treatment — 1. Remove all venous obstruction 
by manipulating the head and 
neck. 

2. Apply pressure with the fingers 
over the frontal sinuses, over the 
sinuses of the superior maxillary 
and ethmoidal bones and on the 
sides of the nose. 

3. Relax the muscles of the occiput, 
face and forehead. 

4. Correct any lesion in the cervical 
region. 

5. Vibrate the fauces, cheeks, inner 



76 TEXT-BOOK OF OSTEOPATHY 

canthi of the eyes, nares, temples, 
angles of the lower jaw and neck. 

6. Raise the clavicles, chest muscles, 
arms and ribs. 

7. Apply pressure along the sides of 
spine, while the patient's arms are 
extended. 

8. Remove all pressure from the 
sympathetic nerve filaments in the 
sphincters. 

9. Open the mouth against resist- 
ance. 

10. Give deep abdominal treatment. 
Treat three times per week. 

CHRONIC BRONCHITIS. 

Definition — This is a chronic inflammation of the 
mucous membrane of the larger and middle-sized 
bronchial tubes, in which cough and more or less 
expectoration are present. There is also a dry form 
where expectoration is entirely absent. 

Causes — Usually follows an acute attack. It may 
be secondary to rheumatism, syphilis, gout, renal, 
cardiac or pulmonary diseases. 

Symptoms — Cough, associated with considerable 
puffiing or shortness of breath, is usually the most 
prominent symptom. The cough does not cause 
pain, is worse in the morning, after meals and at 
night. There is more or less secretion of thick, yel- 
lowish or greenish mucus, which is sometimes 
streaked with blood. Gastro-intestinal disorders 



CHRONIC PLEURISY 77 

are not infrequently present. The tongue is coated, 
there are eructations of gas and the appetite is 
greatly diminished or lost. 

Treatment — 1. Give a general treatment to the 
entire body. 

2. Carefully manipulate the throat 
and chest for the purpose of relax- 
ing the muscles. 

3. Apply stimulation to the second, 
third and fourth ribs. 

4. Place the patient on a stool and 
elevate these ribs by pressing the 
thumb against the heads of the 
ribs and throwing the arms up- 
ward and slightly backward. 

5. Separate the first four ribs. 

6. Separate the costal cartilages by 
placing the fingers between them, 
then turning the fingers and 
spreading the hands at the same 
time. 

7. Remove obstruction to the jugu- 
lar veins by raising the clavicles. 

8. Place the knee in the upper dorsal 
region and bring the arms of the 
patient up and back, the patient 
inhaling deeply at the same time, 
then exhaling as the arms are re- 
leased. 

CHRONIC PLEURISY. 

Definition — A chronic inflammation of the pleura. 



78 TEXT-BOOK OF OSTEOPATHY 

Causes — Non-absorption of fluid in the acute form 
of pleurisy, causing a thickening of the membrane 
and firm adhesions. 

Symptoms — The symptoms of this disease are 
often masked, and the patient frequently does not 
remember having had an acute attack. There may 
be slight irregular fever, night sweats and debility. 
Cough is not constant and dyspnoea is usually ab- 
sent. The patient is not capable of talking for any 
considerable length of time or in a loud voice. An 
examination of the chest will reveal quite pro- 
nounced deformity on the affected side. 

Treatment — 1. Raise the ribs and stretch the in^ 
tercostal muscles. 

2. Relax the spinal muscles. 

3. Manipulate the muscles of the 
neck. 

4. Apply steady pressure on the af- 
fected nerves at their exit from 
the spine. 

5. Raise the clavicles. 

6. Give a . general spinal treatment, 
paying particular attention to the 
tenth, eleventh and twelfth dorsal 
vertebrae. 

7. Stretch the body backward, at the 
same time pressing along the sides 
of the spinous processes with the 
fingers. 

8. Treat the bowels. 
Treat three times weekly. 



PULMONARY TUBERCULOSIS 79 

PULMONARY TUBERCULOSIS. 

Definition — This is a specific infectious disease, 
due to the tubercle bacillus, characterized by the 
formation of tubercles in the lungs, and general sys- 
temic disorders. 

Causes — Tuberculosis occurs in all climates, but 
is most frequently met with in the temperate zone. 
Living in damp, improperly ventilated and over- 
crowded houses predisposes to the contraction of 
this disease. Sedentary habits or occupations favor 
its development and heredity is supposed to have 
something to do with its transmission. It is usu- 
ally not transmitted from parent to child, but a his- 
tory of the disease can be traced back to some gen- 
eration. Any debilitating condition may be suffi- 
cient to permit of its implantation. The exciting 
cause is always the bacillus tuberculosis. 

Symptoms — The onset of this disease may be 
either gradual or abrupt, in many instances coming 
on as an acute cold. The cough is persistent and 
resists all methods of treatment. There is anorexia 
and the patient loses weight and strength without 
apparent cause. The cough is worse in the morn- 
ing and is accompanied by an expectoration of 
whitish or yellowish mucus, which is often tinged 
with blood. The patient usually feels nauseated in 
the morning and is sometimes troubled with hoarse- 
ness. At times, the patient complains of pains in 
the chest or a tightness across the affected area 
and dyspnoea. There is usually an afternoon rise 
of temperature, the face is flushed and night-sweats 
occur in most cases. These sweats are often pro- 



S;: TEXT-BOOK OF OSTEOPATHY 

fuse. Sometimes. the first symptom t: attract at- 
tention may be herttrrhage from the lungs. The 
face becimes pinched, the features sharpened and 
the cyts sunken. The pulse rate is increased, usu- 
ally running from 95 to 100 beats per minute dur- 
ing the early stages of the disease. As the disease 
progresses, all the above mentioned symptoms are 
exaggerate 1 and toward the later stages, edema of 
the ankies occurs. 

Physical Signs — Expansion over the arcected area 
is diminished. vc-cal fremitus is slightly increased, 
the inspiration is harsh and high-pitched, and expi- 
ration is prolonged. The characteristic ' : : g-wreel" 
respiration is titer, present. Mucus raies are usu- 
aky heard at the apexes :f the lungs and sometimes 
at the base. Resonance. ::t percussion, will be 
i o u n c i m p a i r e _* , 

Treatment — 1. igrous treatment to the dorsal 
region from the first to the 





eighth.. 


:. 


r^aise tre rtcs ana separate tit em. 




Have the patient sit :r. a stool. 




o.ace tne -iree in tre zac.o. ant 




draw the arms uoward and tack- 




ward, the patient inhaling deeply 




at the time. 


4. 


Control the night-sweats 




string inhibition in dcrsal regitn. 



5. Inhibit the cervical ganglia to 

slew the heart. 



z Praise tne caw 



-C^. 



HERNIA 81 

7. Thoroughly relax the neck mus- 
cles. 

8. Treat the abdomen. 

9. Relieve pressure and treat indi- 
cations. 

Advise light outdoor exercise and living out in 
the open as much as possible. 

Diet — The patient may be allowed to take : Tur- 
tle or oyster soup, mutton, clam or chicken broth, 
puree of barley, rice, peas, beans, cream of celery 
or tomatoes, whole beef tea, peptonized milk gruel ; 
all kinds of fresh fish boiled or broiled, oysters or 
clams, raw, roasted or broiled; eggs in every way 
except fried; oatmeal, wheaten grits, mush, hom- 
iny, rice, whole wheat bread, corn bread, milk toast, 
biscuits, muffins, gems; potatoes baked, boiled or 
creamed, string beans, spinach, onions, asparagus, 
tomatoes, green peas, all well cooked, cresses, let- 
tuce, plain or with oil dressing, celery ; farina, sago, 
tapioca, apple or milk pudding, custards, baked or 
stewed apples with fresh cream, cooked fruits, rice 
with fresh cream; fresh milk, cool, warm, or pep- 
tonized, cocoa, chocolate, buttermilk, pure water, 
tea, coffee. He must not take any of the follow- 
ing: Fried foods, salt fish, hashes, gravies, veal, 
pork, carrots, parsnips, cabbage, beets, turnips, cu- 
cumbers, macaroni, spaghetti, sweets, pies, pastry, 
sweet wines. 

HERNIA. 

Definition — The term "hernia" or "rupture" is 
given to any abnormal opening in the walls of any 
cavity of the body which permits portions of re- 
tained organs to escape into or through it. It is 



82 TEXT-BOOK OF OSTEOPATHY 

most frequently applied, however, to openings into 
or through the walls of the abdominal cavity. Three 
forms are usually recognized, inguinal, femoral and 
umbilical. 

Causes — The predisposing cause is an imperfect 
closure of the internal ring. There are many excit- 
ing causes, among which muscular weakness of the 
abdominal walls and violent exercise are most com- 
mon. 

Symptoms — The patient first notices a swelling in 
the region affected. The tumor is seldom painful 
and varies in size with the position of the body. It 
generally disappears in the recumbent position. By 
placing the hand over the swelling and asking the 
patient to cough, an impulse is usually felt. A 
gurgling sound is usually heard when the bowel 
returns within the cavity. 

The symptoms of strangulated hernia are pain, 
rapid pulse, vomiting, obstruction and irreducibility 
and an anxious look on the patient's face. If not 
reduced, this condition causes death. 

TREATMENT FOR STRANGULATION. 

Place the patient on the back with the shoulders 
lower than the body. Raise the pelvis and flex the 
limb on the side of the rupture. Strongly flex the 
leg on the thigh, the thigh on the abdomen and at 
the same time press around the hernia in the groin 
with the fingers of the other hand. Flexing one or 
two times usually reduces the hernia. 

TREATMENT FOR THE CURE OF HERNIA. 

Patient on back. Knead the muscles of the ab- 



SPINAL CURVATURE 83 

domen, while the legs are flexed. Free the lumbar 
nerves. 

Treat three times weekly. A cure can be effected 
in about 40 per cent of all cases. 

SPINAL CURVATURE. 

Definition — Scoliosis or Rotary Lateral Curvature 
of the Spine is a complicated distortion in which the 
spine forms two or more lateral curves, with their 
convexities in opposite directions. 

Causes — The most prominent cause in the ac- 
quired form of this disease is the faulty position 
which the child habitually assumes either in walk- 
ing, sitting or standing. Rapid growth, structural 
weakness of the ligaments and bones, heredity, rick- 
ets, a strumous diathesis and general debility are 
often underlying causes. 

Symptoms — Premonitory symptoms are general 
lassitude, pain or a feeling of weakness in the back 
and a stooping gait. The first symptom usually 
noticed is a slight projection of the scapula. The 
right shoulder is generally elevated and the angles 
of the right scapula, right iliac crest and left breast 
are prominent. On account of the backward pro- 
jection of the processes of the left lumbar vertebrae, 
the left lumbar muscles stand out as a prominent 
ridge. 

Treatment — Same as for Pott's disease. 

Lordosis is a curving of the spine in which the 
convexity is forward. 

Kyphosis is a curving of the spine where the con- 
vexity is backward. 

The causes, symptoms and treatment of these con- 
ditions are similar to lateral curvature. 



84 TEXT-BOOK OF OSTEOPATHY 

POTT'S DISEASE— CARIES OF THE SPINE. 

Synonyms — Tuberculosis of the spine, spinal cur- 
vature, spondylitis and caries of the spine. 

Definition — A progressive inflammation of the 
spine, characterized by partial or complete destruc- 
tion of the bodies of the vertebrae and their carti- 
lages, thereby giving rise to deformity. 

Causes — It is met with most frequently in child- 
hood, the greater number of cases occurring be- 
tween the ages of three and ten. It may, however, 
occur at any age. In the majority of cases a his- 
tory of injury will be found the cause. It often 
occurs among children of the poorer class, espe- 
cially where tuberculosis is hereditary. It may fol- 
low many acute infectious fevers. In late life it 
usually follows rheumatism or osteoarthritis. 

Symptoms — These vary greatly and are influ- 
enced by conditions present. Pain is the most 
prominent symptom and is nearly always referred 
to the distribution of the spinal nerves. It is worse 
after standing or after exertion. There is tender- 
ness on pressure, and rigidity of the back and a 
sense of weakness. The deformity depends upon 
the amount of destruction. 

Treatment — 1. Relax the muscles of the spine. 

2. Suspend the patient by the arips. 

3. Adjust the vertebrae properly, by 
beginning at the lowest one 
which is out of position, force it 
over and then work on the next 
in order and so on. 

4. Strengthen the spinal muscles by 



CHRONIC BRIGHT'S DISEASE 85 

manipulation, as well as the liga- 
ments. 
5. Give general and spinal treat- 
ment. 

CHRONIC BRIGHT'S DISEASE. 

Definition — A chronic inflammation of the kid- 
neys affecting their cortical and tubular structures 
and characterized by albuminuria and dropsy, and 
enlargement of the organs. 

Causes — Usually follows an attack of acute 
Bright's disease. It may be caused by intemper- 
ance, living in damp and ill-ventilated houses, grief 
or worry, and frequently follows malaria, syphilis or 
scrofula. It is often met with among poorly fed 
and half-clad persons. It rarely occurs after the 
age of forty. 

Symptoms — The first symptoms noticed are fre- 
quent desire to urinate, swelling of the face or ex- 
tremities, increasing pallor and general debility, 
and headache, which is usually confined to the oc- 
cipital region. As the disease progresses, cardiac 
palpitation, dizziness and difficult or defective vis- 
ion occur. The urine is scanty, high-colored and of 
unchanged specific gravity. It is less acid and 
shows the presence of albumin and tube-casts. The 
amount of albumin may vary from day to day and 
in many cases it may disappear for a short time. 
An irritable bladder often accompanies this dis- 
ease. The only constant and characteristic manifes- 
tations are the profound and increasing anemia and 
the presence of albumin and tube-casts in the urine. 

In interstitial nephritis or contracted kidney, the 



86 TEXT-BOOK OF OSTEOPATHY 

symptoms are practically the same, excepting the 
urinary findings. The specific gravity is low and 
an inconsiderable amount of albumin is present. 
Dropsy is usually absent. 

Treatment — 1. Correct the spinal lesion usually 
present from the tenth dorsal to 
the second lumbar vertebra. 

2. Relax all muscles in this region 
as follows : Place the patient face 
downward and apply steady pres- 
sure upward and downward on 
the muscles in the dorsal and 
lumbar regions. 

3. Stimulate the sacral nerves. 

4. While applying steady pressure 
on the spine with one hand, oscil- 
late the limbs from side to side 
with the other. 

5. With the patient lying on his back 
with leg's and thighs flexed, place 
the fingers under the spine and lift 
him on finger-tip s. 

6. Give a thorough abdominal treat- 
ment at or above the umbilicus. 

7. Regulate the action of the liver 
and bowels. 

Treat three or four times weekly. 

ENURESIS. 

Definition — Incontinence of urine. 

Causes — This condition is most common in chil- 
dren, especially in males. It seldom occurs after 
puberty. Congenital weakness of the sphincter mus- 



DIABETES MELLITUS 87 

cle, acid urine, polyuria, prepucial adhesions and 
phimosis are common causes, and menstruation, in- 
digestion, constipation and intestinal worms fre- 
quently give rise to this disorder. 

Symptoms — An involuntary discharge of urine 
usually occurs at night during the first sleep, or in 
the early morning. 

Treatment — Place the patient face downward on 
a table or couch and take hold of both ankles 
with one hand. Place the other hand on the sides 
of the spinous processes of the sacrum, and while 
pressing hard against the sacrum, raise the feet and 
move them from side to side and then lower them 
to the level of the body. Repeat the same process 
and place the fingers a little higher up the sacrum 
each time, until the whole lumbar region has been 
covered. 

Use vibratory upward movements on the sacrum. 

DIABETES MELLITUS. 

Definition — This is a constitutional disorder aris- 
ing from malnutrition, characterized by an exces- 
sive flow of urine containing sugar. 

Causes — Diabetes may occur at any age, but is 
most common in adults, males and the well-to-do. 
Diseased conditions of the liver and pancreas are 
supposed to be underlying causes. Among the pre- 
disposing causes may be mentioned high living, the 
excessive use of carbohydrates, physical and mental 
overwork, nervous excitement and pregnancy. It 
not infrequently follows such diseases as Malaria, 
Influenza and Gout. 

Symptoms — These usually appear gradually, and 
the patient is not aware that he is suffering from 



88 TEXT-BOOK OF OSTEOPATHY 

Diabetes until he has had his urine examined for 
some reason or other. The first symptom noticed 
is the large amount of urine passed and its fre- 
quency. Accompanying symptoms are thirst, which 
is usually great, weakness and debility and a grad- 
ual loss of weight. Headache is often present, the 
patient is irritable and subject to insomnia. There 
is a disordered digestion, although digestion may 
remain good. 

The urine has a high specific gravity, usually 
from 1.025 to 1.060, and is of a pale color. Sugar 
is present in varying quantities, usually from y 2 to 
2 per cent. The total amount excreted in twen- 
ty-four hours may reach a pound. If the urine is 
allowed to stand it does not decompose, but becomes 
turbid. The quantity of urea is increased. Albu- 
min may be present. 

Treatment — Manual and Dietetic. 

1. Begin by giving a general treat- 
ment. 

2. Correct lesions between the 
eighth dorsal and second lumbar 
vertebrae. 

3. Give strong inhibitory treatment 
to the spine from the lower dorsal 
to the sacrum, also in the region 
of the bladder and ischio-rectal 
fossa. 

4. Flex the legs and thighs. 

5. Spring the spine forward while 
the legs and thighs are flexed. 

6. Apply pressure to the spine in the 
dorsal and lumbar regions, while 



DIABETES MELLITUS 89' 

lifting the shoulders and throwing 
them backward. The patient 
should assume the sitting posture 
during this movement. 
7. Vibrate the spine. 
Every case must' be treated individually and ac- 
cording to indications. 

Diet. — 1. The patient may be allowed to take 
soups of all kinds (not thickened with any farina- 
ceous substances) and beef tea. 

2. Shell fish and all kinds of fish, fresh, salted, 
dried, pickled or otherwise preserved (no dressing 
containing flour). 

3. Eggs in any way most acceptable. 

4. Meats of all kinds, excepting liver (all cooked 
free of flour, potatoes, bread or crackers). 

5. Gluten bread and cakes, also bran bread and 
cakes. 

6. Vegetables : String beans, spinach, beet-tops, 
chicory, kale, lettuce, plain or dressed with oil and 
vinegar, cucumbers, onions, tomatoes, mushrooms, 
asparagus, oyster plant, celery, dandelions, cresses, 
radishes, pickles and olives. 

7. Desserts: Custards, jellies, creams (without 
sugar), walnuts, almonds, filberts, Brazil nuts, co- 
coanuts and pecans. 

8. Drinks: Tea or coffee (without sugar), pure 
water, peptonized milk. 

9. MUST NOT TAKE sugars, sweets or 
starches of any kind, wheaten bread or biscuits, corn 
bread, oatmeal, barley, rice, rye bread, arrowroot, 
sago, macaroni, tapioca, vermicelli, potatoes, pars- 
nips, beets, turnips, peas, carrots, melons, fruits, 



90 TEXT-BOOK OF OSTEOPATHY 

puddings, pastry, pies, ices, honey, jams, sweet or 
sparkling wines, cordials, cider, porter, lager, chest- 
nuts and peanuts. 

Prognosis — Unfavorable, but life may be length- 
ened by proper care. 

RHEUMATISM— ACUTE AND CHRONIC. 

Definition — A constitutional disease characterized 
by inflammation of the connective tissue structures 
of the body, especially the muscles and joints, and 
attended by pain, acid sweats and a tendency to 
endocarditis. 

Causes — Predisposing causes of this disease are 
debility from overwork, bad food, unsanitary sur- 
roundings and malaria. Exciting causes are expo- 
sure to cold and wet causing a sudden chilling of the 
surface of the body, especially when over-heated. 
Heredity is believed to exercise a certain influence. 
Robust middle-aged males are oftenest affected, par- 
ticularly those most exposed to vicissitudes of 
weather. 

Symptoms — Anorexia, dyspepsia, malaise and 
wandering pains may precede an acute attack for 
two or three days, but the onset is usually sudden. 
An attack is commonly ushered in with a chill or 
chilly sensations, the temperature rises rapidly, the 
thermometer indicating an elevation of from 103° 
to 104° F., within twenty-four hours. The tongue 
is coated and the patient complains of headache. The 
pulse is full and soft and seldom exceeds 100 per 
minute. The patient perspires profusely and the 
skin is covered with acid sweat. The urine is scanty, 
and on standing it deposits a considerable amount 



RHEUMATISM— ACUTE AND CHRONIC 91 

of urates. An eruption of miliaria often appears on 
the surface. There is swelling, redness and pain 

d the affected parts are very tender to the touch. 

he large joints are most apt to be involved, such 
as the knee, ankle, shoulder, wrist and elbow, but 
the fingers and toes may be implicated. The in- 
flammation has a tendency to subside in one joint 
and appear simultaneously in another. Endocardi- 
tis is liable to develop. 

In the chronic form, the symptoms come on grad- 
ually, there is slight soreness and stiffness, noticed 
more particularly during damp and cloudy weather 
or on the day following some laborious occupation. 
There is slight tenderness on pressure, but the joints 
are only slightly swollen and are not red. Suf- 
fering is worse at night. Febrile symptoms are 
rarely present. v 

An attack of muscular rheumatism usually comes 
on suddenly, with pain in the affected muscles, ten- 
derness and considerable stiffness, making move- 
ment difficult and painful. Hyperexia is usually 
absent. The causes are practically the same as in 
the other varieties of rheumatism. 

General treatment in all forms of rheumatism : 

1. Give a general treatment. 

2. Thoroughly manipulate the neck, spine, 
shoulders, clavicles, chest-muscles and vaso-motor 
area. 

3. Begin where the slightest or no soreness is 
present and knead the tissues. 

4. Treat the kidneys, liver and intestines. 

5. Manipulate the joints gently. 

6. Correct any spinal lesions. 



92 TEXT-BOOK OF OSTEOPATHY 

7. Separate the ribs. 

8. Apply steady pressure over affected nerves. 

9. Carefully stretch the joints to allow better 
circulation. 

10. Relax the muscles in the dorsal and lumbar 
regions. 

Apply cold compresses or hot fomentations. 
Treat two or three times daily in acute form, two 
or three times weekly in chronic. 

RHEUMATOID ARTHRITIS. 

Definition — An inflammation of the joints, caus- 
ing enlargement and deformity of various articula- 
tions. 

Causes — Bad hygiene, exposure, tubercular dia- 
thesis, frequent pregnancies and prolonged lactation, 
grief and the menopause. It often follows attacks 
of articular rheumatism. It is more frequent in fe- 
males than males, and in the weak and anemic. 

Symptoms — The acute form involves several 
joints at a time and slight fever may be present, 
while in the chronic stage only one joint is affected 
at the same time. Each joint is subject to recur- 
rent attacks. The joint enlarges slowly, and move- 
ment causes pain. After a time the redness and ten- 
derness disappear and the articulation becomes rig- 
id or slightly movable. Crepitation can often be 
felt. The hands are usually involved, but the dis- 
ease may spread to every joint. 

Treatment — 1. Give a general treatment. 

2. Correct any spinal lesions present. 

3. Manipulate the nerves to the 
joints and thoroughly massage the 
surrounding structures to bring 



GOUT 93 

about absorption and assist in 
drainage. 

4. Equalize the circulation by prop- 
er treatment. 

5. Flex and extend the affected 
joints. 

Hydrotherapy in the form of hot full baths can 
be used with some benefit. 

Prognosis — Guarded. Very often incurable. 

GOUT. 

Definition — Gout is a constitutional disease, char- 
acterized by an excess of uric acid or alkaline urates 
in the fluids of the body. 

Causes — It is most frequent in males and middle 
or advanced life. Heredity seems to have some in- 
fluence in this disease. The principal causes are riot- 
ous living, over-indulgence in spirituous and malt 
fiquors, and an inactive life. 

Symptoms — The disease usually commences with 
an acute attack, as the result of inactivity of the 
liver, or of indigestion. It usually comes on with 
sharp shooting pains through the joints, especially 
when the limbs are flexed. The patient is irritable 
and suffers greatly from the pain and inflammation. 
The pain is severe in the great toe, this member be- 
coming swollen and inflamed and very tender to the 
touch. The temperature is increased, usually be- 
tween 101-103° F. All symptoms seem worse in 
the early morning hours. The symptoms subside 
during the following day and reappear the next 
morning and may recur in this manner for several 
days. The urine shows a deposit of "brick-dust" 



94 TEXT-BOOK OF OSTEOPATHY 

colored crystals of uric acid and urates. All symp- 
toms gradually subside and may not recur again for 
a long time, or the joints may become filled with 
chalky deposits and cause deformity or immobility 
and the disease takes on a chronic form. 
Treatment- — 1. Give a general treatment. 

2. Stimulate the kidneys. 

3. Treat the spine, especially at the 
lower and lumbar regions. 

4. If the great toe is painful, begin 
the treatment in the lower part of 
the back and work slowly, care- 
fully and thoroughly down the 
limb to the toe. 

5. Gently manipulate the joint from 
side to side and carefully stretch 
same. 

6. Assist in re-establishing proper 
circulation by manipulating and 
moving all the tissues to the bone. 

7. Instruct the patient to bathe fre- 
quently. If the patient is strong, 
advise cold baths in the morning, 
followed by vigorous rubbing with 
a coarse towel. 

The patient should be treated at least three times 
a week. 

SCIATICA. 

Definition — A painful affection of the sciatic 
nerve. Neuralgia of the sciatic nerve. 

Causes — Predisposing causes are rheumatic dia- 
thesis, diabetes and some of the infectious diseases. 
Exciting" causes are exposure to cold or wet heavy 



SCIATICA 95 

muscular exertion, injuries to the nerve, pressure 
of tumors and constipation. 

Symptoms — The most prominent symptom is 
pain along the course of the sciatic nerve. The pain 
is usually paroxysmal and is sharp and lancinating 
and increased by motion. The pain may be con- 
fined to a part of its course only. It comes on sud- 
denly or gradually. The nerve is very tender along 
its course and particularly at the sciatic notch. 
Slight fever may be present during the acute stage, 
and also numbness. 

Treatment — 1. Relax all muscles in the lumbar 
region. 

2. Rotate the thigh inward in the 
following manner: Flex the leg 
on the thigh and take hold of the 
ankle. Hold the knee and turn 
the leg so as to rotate the thigh. 

3. Flex the thigh on the abdomen 
and the leg on the thigh, then 
straighten the leg, while thigh is 
still flexed. This stretches the 
sciatic nerve. 

4. Manipulate the popliteal space. 

5. Apply pressure with the thumbs 
on the sides of the spines of the 
lower lumbar vertebrae. 

6. Deeply manipulate all the mus- 
cles of the hip and upper portion 
of the thigh. 

7. Flexion, extension, adduction and 
abduction of the lower limbs 
should be performed. 



96 TEXT-BOOK OF OSTEOPATHY 

8. Vibrate the dorsal, lumbar and 
gluteal areas. 
Treat every other day. Every day in severe cases. 

TORTICOLLIS. 

Definition — Wry neck. This is an affection due 
to a contraction of the sternocleido-mastoid muscle, 
causing a twisting of the head. 

Causes — This condition may be either congenital 
or acquired. 

Congenital wry neck is usually noticed soon after 
birth. Its origin is not certain, but is supposed to 
be due to a rupture of the muscle at the time the 
infant is born. 

The acquired form may be the result of rheuma- 
tism or exposure to cold. It may also arise as a 
symptom of inflammation of the lymphatic glands, 
the vertebrae or other structures of the neck. 

Symptoms — This condition is not difficult to rec- 
ognize. Usually the only symptom present is the 
stiffness on one side of the neck and inability to 
straighten the head. 

Treatment — 1. Thoroughly relax all muscles and 
tissues of the neck. 

2. Place one hand on the sterno- 
cleido-mastoid muscle near the 
entrance of the eleventh nerve, 
and with the other hand turn the 
neck as far as possible each way. 

3. Rotate the head under tension. 

Prognosis — Good in recent cases. Cases of long 
standing are incurable. 



<6 



>7 



